Orthopedics Book

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Shoulder Exam

Aka: Shoulder Exam
  1. See Also
    1. Shoulder Anatomy
    2. Shoulder History
    3. Shoulder Pain
  2. Exam: Inspection (from all angles and with Shoulder fully exposed)
    1. Swelling and Bruising in recent Trauma
    2. Scars suggesting old Trauma
    3. Deformity
      1. Acromioclavicular joint
      2. Clavicle
      3. Glenohumeral joint (in acute dislocations)
    4. Asymmetry
      1. Disuse atrophy of the supraspinatus muscle
        1. Chronic Rotator Cuff Tear or Shoulder Impingement
        2. Efficacy of atrophy as test for Rotator Cuff Syndrome
          1. Test Sensitivity: 56%
          2. Test Specificity: 73%
      2. Shoulder sag
        1. Cranial Nerve 11 disorder
      3. Sulcus at glenohumeral joint
        1. Seen with acute Shoulder Dislocation
  3. Exam: Palpation
    1. Grading of pain
      1. No pain: 0
      2. Mild pain: 1
      3. Moderate: 2
      4. Severe: 3
    2. Technique
      1. Both Shoulders exposed
      2. Palpate for atrophy or swelling
      3. Assess contour of Shoulder
      4. Palpate for tenderness in both Shoulders
        1. Acromioclavicular (AC) joint
          1. Acromioclavicular Joint Osteoarthritis or
          2. AC Seperation
        2. Biceps Tendon tenderness
          1. Bicipital Tendonitis
        3. Greater tuberosity of Humerus (and supraspinatus)
      5. Palpate fibromyalgia Tender Points at occiput and medial trapezius muscle
        1. Assess for comorbid myofascial pain
  4. Exam: Specific Shoulder Tests (see categories below for full descriptions)
    1. Shoulder Range of Motion
      1. See Shoulder Range of Motion (forward flexion, abduction)
      2. Apley Scratch Test (internal and external Shoulder rotation)
    2. Shoulder Strength Exam
      1. French Horn Shoulder Test
      2. Lift-Off Subscapularis Test
      3. Empty Cans Test or Full Cans Test (Supraspinatus)
      4. Drop Arm Test (Supraspinatus)
      5. Speed's Test (Bicipital tendon)
      6. Yergason Test (Bicipital tendon)
      7. Rotator Cuff Triad Test (Rotator Cuff Tear)
    3. Shoulder Instability Exam
      1. Shoulder Apprehension Test (and Relocation)
      2. Shoulder Crossover Maneuver (AC Joint disease)
    4. Shoulder Impingement Signs
      1. Neer Test (Shoulder Internal Rotation and forward flexion)
      2. Hawkins Test (Internal and external rotation)
      3. Empty Cans Test (Supraspinatus)

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