American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary complaint of patients suffering from adhesive capsulitis?

1. Pain with passive range of motion

2. Loss of active range of motion

3. Swelling in the shoulder joint

4. Itching around the shoulder area

The correct answer is: Loss of active range of motion

The primary complaint of patients suffering from adhesive capsulitis, commonly known as frozen shoulder, is the loss of active range of motion. This condition is characterized by a gradual onset of shoulder stiffness and significant limitation in the ability to move the shoulder actively. Patients often find it difficult to perform everyday activities, such as reaching overhead or behind their back, due to this loss of motion. While pain can be associated with adhesive capsulitis, especially during movement, it is the restriction of movement that is more prominent and bothersome to the patient. In this condition, the capsule of the shoulder joint becomes thickened and tight, leading to both passive and active range of motion difficulties; however, the inability to actively move the shoulder highlights the primary functional impairment experienced by patients. Swelling around the joint can occur in some cases but is not a central complaint or characteristic feature of adhesive capsulitis. Itching is unrelated to this condition and is not a symptom experienced by patients suffering from this shoulder issue. Thus, the emphasis on loss of active range of motion helps clarify the hallmark complaint in patients with adhesive capsulitis.