Table 1.

Stages of adhesive capsulitis (adapted from Hannafin and Chiaia CORR [2])

	Description
Stage 1	Duration of symptoms 0–3 months
	Pain with active and passive ROM
	Limitation of forward flexion, abduction, internal rotation, external rotation
	EUA: normal or minimal loss of ROM
	Arthroscopy: diffuse glenohumeral synovitis
	Pathology: hypertrophic, hypervascular synovitis; rare inflammatory cell infiltrates, normal capsule
Stage 2	Duration of symptoms 3 to 9 months
	Chronic pain with active and passive ROM
	Significant limitation of forward flexion, abduction, internal rotation, external rotation
	EUA: no change in ROM compared with when patient is awake
	Arthroscopy: diffuse, pedunculated synovitis
	Pathology: hypertrophic, hypervascular synovitis with perivascular and subsynovial scar, fibroplasias, and scar formation in the underlying capsule
Stage 3	Duration of symptoms 9 to 15 months
	Minimal pain except at end ROM
	Significant limitation of ROM with rigid “end feel”
	EUA: no change in ROM compared with when patient is awake
	Arthroscopy: no hypervascularity seen; remnants of fibrotic synovium. Diminished capsular volume
	Pathology: “burned out” synovitis without significant hypertrophy or hypervascularity. Dense scar formation of the capsule
Stage 4	Duration of symptoms: 15 to 24 months
	Minimal pain
	Progressive improvement in ROM

ROM Range of motion, EUA examination under anesthesia