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Physical examination of the shoulder

Authors
Stephen M Simons, MD, FACSM
J Bryan Dixon, MD
Section Editor
Karl B Fields, MD
Deputy Editor
Jonathan Grayzel, MD, FAAEM

INTRODUCTION

The evaluation of patients with shoulder dysfunction or pain can be difficult. Skillful examination of the shoulder is an integral part of this evaluation and is necessary to generate an appropriate differential diagnosis and to help determine whether advanced imaging is needed.

The large number of shoulder examination techniques, often named for their originators, can be confusing. In addition, although these maneuvers are often taught as if they are pathognomonic for a particular pathology, their diagnostic accuracy is often uncertain and many studies designed to assess their test characteristics (eg, sensitivity, specificity) are difficult to interpret [1]. As an example, multiple examination maneuvers may yield positive results in a patient with an acutely injured shoulder, thereby reducing specificity.

This topic reviews the examination of the shoulder, including many special tests designed to detect particular lesions. A systematic approach to the patient with shoulder complaints and discussions of specific shoulder problems are found separately. (See "Evaluation of the patient with shoulder complaints" and "Shoulder impingement syndrome" and "Rotator cuff tendinopathy" and "Presentation and diagnosis of rotator cuff tears" and "Acromioclavicular joint disorders" and "Frozen shoulder (adhesive capsulitis)" and "Glenohumeral osteoarthritis" and "Radiologic evaluation of the painful shoulder" and "Overview of upper extremity peripheral nerve syndromes", section on 'Proximal neuropathies'.)

ANATOMY AND BIOMECHANICS

A complex network of anatomic structures endows the human shoulder with tremendous mobility. These structures and the related biomechanics are discussed separately. (See "Evaluation of the patient with shoulder complaints", section on 'Anatomy and biomechanics'.)

TIPS FOR A PRODUCTIVE EXAMINATION

The following tips may be helpful for performing the shoulder examination effectively and efficiently:

                              

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Literature review current through: Nov 2016. | This topic last updated: Tue Dec 15 00:00:00 GMT+00:00 2015.
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