Clinical Identifiers for Early-Stage Primary/Idiopathic Adhesive Capsulitis: Are We Seeing the Real Picture?

Background. Adhesive capsulitis is often difficult to diagnose in its early stage and to differentiate from other common shoulder disorders. Objective. The aim of this study was to validate any or all of the 8 clinical identifiers of early-stage primary/idiopathic adhesive capsulitis established in an earlier Delphi study. Design. This was a cross-sectional study. Methods. Sixty-four patients diagnosed with early-stage adhesive capsulitis by a physical therapist or medical practitioner were included in the study. Eight active and 8 passive shoulder movements and visual analog scale pain scores for each movement were recorded prior to and immediately following an intra-articular injection of corticosteroid and local anesthetic. Using the local anesthetic as the reference standard, pain relief of 70 % for passive external rotation was deemed a positive anesthetic response (PAR). Results. Sixteen participants (25%) demonstrated a PAR. Univariate logistic regres-sion identified that of the proposed identifiers, global loss of passive range o