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Shoulder examination

Look     [Back To Top] 

From the front, side and above

  • Asymmetry, scars, deltoid wasting, SCJ or ACJ deformity, swelling of the joint

From behind

  • Look and feel for rotator cuff wasting, scapula shape and situation e.g. winging, Sprengel shoulder etc

Feel     [Back To Top] 

  • SCJ to the ACJ and acromion
  • Greater and lesser tuberosity, feel for rotator cuff defects
  • Glenohumeral joint: anterior and posterior aspects
  • Biceps tendon/bicipital groove
  • Spine of scapula

Move     [Back To Top] 

ALWAYS EXAMINE THE CERVICAL SPINE FIRST

  • Move both arms at the same time. Active then passive ROM.
  • Quick screening test: "Arms above the head and behind the back "
  • Flexion : 0-180 o
  • Abduction : 0-180 o check for painful arc and watch the scapulothoracic rhythm
  • If restricted then repeat with the scapula fixed to check for the amount of glenohumeral movement
  • Internal rotation: T4
  • External rotation : 70 o

Feel for crepitation during motion

Special tests     [Back To Top] 

1. Impingement    [Back To Top] 

  • Neer's sign: Hold scapula down, pronate forearm and flexion will cause pain
  • Hawkin's test: Flexion to 90 o internal rotation will cause pain
      Hawkins Test
  • Neer's test: Pain caused by Neer's test eliminated by local anaesthetic injection
  • Scarf test: forced cross body adduction in 90 o flexion, pain at the extreme of motion indicative of ACJ pathology
    Scarf Test

2. Rotator cuff

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