Shoulder Examination

A structured shoulder exam to separate rotator cuff, joint and referred pain.

Video lesson

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Key points

Compare active and passive range of motion. Painful arc between 60 and 120 degrees suggests impingement. Loss of passive external rotation suggests adhesive capsulitis or glenohumeral arthritis.

Practical approach

Rotator cuff tests: empty can (supraspinatus), resisted external rotation (infraspinatus), lift-off or belly press (subscapularis). Hawkins and Neer for impingement. Examine the neck to exclude cervical radiculopathy.

Pearls

Bilateral shoulder pain and stiffness in an older adult with raised ESR suggests polymyalgia rheumatica.

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At a glance