Shoulder examination

A Shoulder examination (or shoulder exam) is a portion of a physical examination used to identify potential pathology involving the shoulder. It should be conducted with both shoulders exposed to assess for asymmetry and muscle wasting.

Elements of the shoulder exam

Provocative maneuvers specific to the shoulder examination

Tests for rotator cuff pathology

Tests for bicipital tenosynovitis and labral pathology

Tests for shoulder instability

  • Apprehension test or Jobe's test: positive test indicates anterior glenohumeral instability
  • Relocation test

Other tests

A meta-analysis in 2008 concluded that the diagnostic accuracy of individual tests in the shoulder examination was limited, specifically that the Hawkins-Kennedy test and the Speed test have no discriminatory ability to diagnose specific shoulder pathology, and that results of studies evaluating other tests were too statistically heterogeneous to make meaningful conclusions about their diagnostic accuracy.[3]

Examination of the shoulder can be complex because the shoulder can present with more than one pathology at a time.[4]

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References

  1. THOMAS W. WOODWARD, M.D.; THOMAS M. BEST, M.D. (May 15, 2000). "The Painful Shoulder: Part I. Clinical Evaluation". Am Fam Physician. 61 (10): 3079–3088. PMID 10839557.
  2. "Musculoskeletal Shoulder Examination: Shoulder Exam Maneuvers". University of Michigan. Retrieved 5 August 2013.
  3. Hegedus EJ, Goode A, Campbell S, Morin A, Tamaddoni M, Moorman CT 3rd, Cook C. (February 2008). "Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests". Br J Sports Med. 42 (2): 80–92, discussion 92. doi:10.1136/bjsm.2007.038406. PMID 17720798.CS1 maint: multiple names: authors list (link)
  4. Edward G. McFarland; Tae Kyun Kim (30 June 2006). Examination of the shoulder: the complete guide. Thieme. ISBN 978-3-13-141091-7. Retrieved 25 June 2011.
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