Execution
- 1Confirm a history of progressive painful shoulder stiffness, commonly idiopathic or following a period of forced inactivity / trauma.
- 2Assess active and passive shoulder ROM in all directions, comparing with the opposite side.
- 3Identify a capsular pattern, with external rotation most limited, followed by abduction and then internal rotation.
- 4Observe scapulohumeral rhythm during elevation for reverse rhythm or shoulder hiking / shrugging.
- 5Exclude competing causes such as glenohumeral arthritis, large rotator cuff tear, fracture, neurological weakness, or severe pain inhibition.
Positive outcome
A positive diagnostic pattern is painful loss of both active and passive ROM, especially external rotation, with a capsular pattern and compensatory scapular elevation / shrugging. The diagnosis is clinical and exclusion-based rather than one single special test.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Lewis (2015) | NA | NA | NA | NA | NA |
| Kelley et al. (2013) — clinical practice guideline | NA | NA | NA | NA | NA |
CommentMagee frames frozen shoulder as capsular-pattern stiffness with reverse scapulohumeral rhythm and shrugging during elevation. This entry is a diagnostic algorithm, not a discrete orthopedic test. Use it to structure clinical reasoning and exclusion rather than to assign a single Sn / Sp value.
Low Clinical Value