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Examination of Shoulder Joint-1

This document provides an examination checklist for evaluating a patient's shoulder joint. It includes steps to take a history of present illness and activities of daily living. The physical examination involves inspecting for deformities, palpating areas for tenderness, and measuring range of motion during various movements. Special tests evaluate the rotator cuff, impingement, apprehension, and other potential issues. Upon completion, the examination aims to determine any anatomical or pathological diagnoses, which may require further lab tests, x-rays, or MRI to investigate the specific shoulder problem.

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283 views3 pages

Examination of Shoulder Joint-1

This document provides an examination checklist for evaluating a patient's shoulder joint. It includes steps to take a history of present illness and activities of daily living. The physical examination involves inspecting for deformities, palpating areas for tenderness, and measuring range of motion during various movements. Special tests evaluate the rotator cuff, impingement, apprehension, and other potential issues. Upon completion, the examination aims to determine any anatomical or pathological diagnoses, which may require further lab tests, x-rays, or MRI to investigate the specific shoulder problem.

Uploaded by

adi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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EXAMINATION OF SHOULDER JOINT


CHIEF COMPLAINTS;–
H/o pain ,
H/o deformity,
H/o giving away,
H/o any abnormal swelling (exostoses)

HISTORY OF PRESENTING ILLNESS;-eloborate on chief complaints


ADL;- any limitation in combing hair, holding support in bus , putting on shirt or brassire ,
etc
Negative H/o:- H/o trauma, / intramuscular injection(deltoid contracture) / Constitutional
symptoms.(TB) / H/o fever / H/o Seizures/ H/o voluntary reductions(multiaxial instability) /
H/o Neurovascular deficiency / H/o sporting events .

LOCAL EXAMINATION ;–

Attitude & deformity ;– In most conditions like dislocation # clavicle, # SOH, patient
holds the limb with opp. Hand supported
In elbs palsy – flexion – Adduction– Intn rotation- at the shoulder
In deltoid fibrosis – arm is held in abduction

INSPECTION;-

1.Examination Anteriorly – look for deltoid bulge, Supra & Infra clavicular fossa ,AC
joint bulge, Pectoral bulge , Loss of roundness of deltoid, Any stooping / flattening /
scars / sinuses .
2. Examination from side – Look for deltoid bulge / wasting/ scar / sinuses .
3 .Examination from top – AC joint elevation, angle of acromion/ suprascapular
wasting.
4. Examination from back – any stooping / AC joint elevation / scapular broadening,
Angle of scapular, Level of scapula, Spine of scapula
1. Bony arches – Look for clavicle / sterno clavicular ,/ AC clavicular / Scapula

PALPATION : -
Superficial: – Local rise in Temp. / hypo – hyper -aesthesia / Supl tenderness
(keloid)_
Deep Palpation –fibrosis of deltoid,/ Tenderness at AC joint,/ clavicle, /scapula

Bony palpation;–
a) Clavicle – Look for irregularity, abnormal mobility, Crepitus
b) Sterno Clavicular & Ac Clavicular jt. Tenderness, and its relative positions
c) Upper end humerus – palpate for greater tuberosity, metaphyseal area for thickening
(Medial epicondyle shows direction of the head, lateral epicondyle shows the
direction of greater tuberosity )
d) Scapula examination – look for spine, angle, acromion , borders, levels
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MOVEMENTS;-

Flexion 0 – 120degpure GH.(150 deg Pect – major/ minor


GH/AC/SC/ST.)(180 with
lumbar hyperextn
Etn. 0 – 55 L dorsi
Add 0 Subscapularis
Abd 0 – 150 GH-90deg)(150 deg 15 deg. Supra spinitus
GH/AC/SC/ST) 15 – 90 deg. – deltoid
ER 70 – 90 Infra spinitus, t minor,
posterior fibers of delta

IR 0 - 70 Sub scapularis, P major

Scapular Protraction
Scapular retraction

MEASUREMENTS:-
1. Length of the arm – linear; – angle of accromiom to lat. Epicondyle
Circumferential; – around the axilla(girth) and mid arm to – look
for wasting .

Examination of Neuro Vascular and Lymphatic system ;- look for regimental badge
sign (axillary nerve injury you will tend to miss in dislocations be careful )

Special tests: -
1. SHOULDER DISLOCATION TEST :-Hamilton ruler test / Callaway test/ Dugas
test.
2. IMPINGMENT TESTS:-Neers test/Hawkins kennedy test.
3. TESTS FOR ROTATOR CUFF INTEGRITY :- Jobe empty can test, Drop arm test,
Belly press test /lift off test.
4. TESTS FOR APPREHENSION TESTS :-Apprehension test/relocation test
5. Test for brachial plexus – Axillary, radial, thoracic inlet syndrome, Yergason test,
drop arm test
6. TEST FOR SLAP LESION :-O BRIEN TEST(Forward flex shoulder to 90+addn15
deg+IR+elbow straight +thumb pointing downwards.
CRANK TEST – Compression rotation testfor slap
7. TESTS FOR ACJ :-horizontal adduction test
8. TESTS FOR BICEPS TENDON :- speed and yergason test

DIAGNOSIS;- ANATOMICAL- Which part of shoulder, humerus, glenoid ,


tuberosity , Surgical neck, or any tendon surrounding the joint is involved etc

PATHOLOGICAL-Dislocation, tendinitis, tendon rupture, impingement etc


INVESTIGATIONS :-
2

Laboratory – Hb,WBC,TCDC,ESR,
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Radiological and Special investigations – Xray and MRI


 

 
 

SELF NOTES
 

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