Prevalence and Clinical Associations of Adhesive Capsulitis Among Patients Presenting to a Tertiary Shoulder Clinic: A Cross-Sectional Study

BackgroundAdhesive capsulitis (AC) is a debilitating disorder characterized by painful restriction of glenohumeral motion.In tertiary referral centers, patients are frequently referred with MRI reports indicating rotator cuff tears (RCTs).Clinicians may inadvertently attribute symptoms entirely to structural cuff defects, thereby underdiagnosing coexisting AC.This study aimed to determine the prevalence of clinically diagnosed AC among new patients referred to a tertiary shoulder clinic with suspected rotator cuff pathology and to evaluate its relationship with MRI-confirmed RCTs. MethodsA cross-sectional observational study was conducted at the Shoulder Clinic, Royal Rehabilitation Center, King Hussein Medical City (KHMC), Jordanian Royal Medical Services (JRMS), Amman, Jordan, between July 1, 2026, and October 1, 2026.All consecutive, newly referred adult patients presenting with shoulder complaints were screened.A clinical diagnosis of AC was established independently by two fellowshiptrained shoulder surgeons based on restriction of passive range of motion (PROM) in at least two planes of movement.Plain radiographs were obtained for all patients to exclude secondary causes of stiffness, including glenohumeral osteoarthritis, fractures, dislocations, and rotator cuff arthropathy.Shoulder MRI reports were reviewed for structural RCTs.Demographic data and clinical characteristics were analyzed. ResultsA total of 62 consecutive new patients were evaluated (mean age: 55.82 ± 9.49 years; range: 30-82 years; 35 (56.5%) female).Pain was the primary complaint in 52 (83.9%) cases, while the mean symptom duration was 6.92 ± 5.89 months.Clinical evidence of AC (passive motion restriction in ≥2 planes) was present in 36 patients (58.1%), whereas MRI demonstrated RCTs in 39 patients (62.9%).Among patients with MRIconfirmed RCTs, 23 (59.0%) exhibited concomitant clinical AC.Conversely, among 23 patients without RCTs on MRI, 13 (56.5%)had clinical AC.Chi-square analysis demonstrated no statistically significant association between MRI-diagnosed RCTs and clinical AC (χ² = 0.036, p = 0.850), with poor diagnostic agreement (κ = 0.024).No significant associations were observed between RCT status and age, sex, hand dominance, affected side, chief complaint, or symptom duration. ConclusionsAC is highly prevalent among new patients referred to tertiary shoulder clinics and frequently coexists with radiologically diagnosed rotator cuff pathology.Clinicians must prioritize routine physical examinations emphasizing PROM over sole reliance on MRI reports to avoid diagnostic misattribution and ensure appropriate, targeted management.