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 
regression identified that of the proposed identifiers, global loss of passive 
range of movement (odds ratio [OR]=0.26, P=.03), pain at the end of range of all 
measured active movements (OR=0.06, P=.02), and global loss of passive 
glenohumeral movements (OR=0.23, P=.02) were associated with a PAR. Following 
stepwise removal of the variables, pain at the end of range of all measured 
active movements remained the only identifier but was associated with reduced 
odds of a PAR.
LIMITATIONS: The lack of a recognized reference standard for diagnosing 
early-stage adhesive capsulitis remains problematic in all related research.
CONCLUSIONS: None of the clinical identifiers for early-stage adhesive 
capsulitis previously proposed by expert consensus have been validated in this 
study. Clinicians should be aware that commonly used clinical identifiers may 
not be applicable to this stage.