Introduction to Shoulder Exam

The shoulder exam is a critical assessment tool for diagnosing musculoskeletal conditions. It includes inspection, palpation, range of motion, and special tests to evaluate the joint's function and integrity.

Begin by observing the shoulder's contour, symmetry, and muscle atrophy. Look for scars, swelling, or deformities. Note any abnormalities, as these can indicate conditions such as dislocation or rotator cuff tear.

Palpate the joint for warmth, tenderness, or masses. Specific areas include the acromioclavicular joint, biceps tendon, and subacromial space. Unexpected findings might suggest arthritis, tendinitis, or impingement syndromes.

Assess both active and passive range of motion. Limitations can be due to pain, stiffness, or mechanical blockage. Frozen shoulder typically presents with a global restriction pattern in movements.

Perform strength tests like Jobe's test for rotator cuff integrity. Special tests, such as Hawkins-Kennedy or the drop-arm sign, help isolate specific conditions. These tests can unveil subtle injuries often missed in general examination.

Assess the axillary nerve function by checking deltoid muscle strength and sensation over the lateral shoulder. Circulation is checked by palpating the radial pulse. Abnormal findings may indicate nerve entrapment or vascular compromise.

Conclude with a comprehensive functional assessment. Perform specific maneuvers to replicate the patient's pain or discomfort. This holistic approach often reveals hidden pathologies and aids in forming a precise diagnosis.