Rheumatology‎ > ‎

Shoulder Pain

    • Etiology
      • Intrinsic
        • Periarticular
          • Impingement Syndromes
            • Supraspinatus Tendonitis
            • Subdeltoid Bursitis
            • Rotator Cuff Tear
          • Biceps Tendonitis
          • Calcific Tendonitis
          • AC joint arthritis
        • Glenohumeral Disorder
          • Inflammatory / Septic arthritis
          • OA
          • Osteonecrosis
          • Cuff arthropathy
          • Glenoid Labral tear
          • Adhesive Capsulitis
          • Glenohumeral instability
      • Extrinsic
        • Regional Disorder
          • Cervical Radiculopathy
          • Brachial Neuritis
          • Nerve entrapment syndrome
          • Sternoclavicular arthritis
          • Reflex sympathetic dystrophy
          • Fibrositis
          • Other causes
    • Shoulder Examination
      • Inspection: Symmtery, Muscle atrophy (Supraspinatus and Infraspinatus atrophy)
      • Palpation:  Acromioclavicular Tenderness
      • Range of Motion:
        • Active:
        • Passive:
      • Provocative Tests
        • Hawkins': Impingement / Rotator cuff disorder (RCD)
        • Drop-arm: Large Rotator cuff tear
        • Empty-can supraspinatus: RCD involving supraspinatus 
        • Lift-off Subscapularis: RCD involving subscapularis
        • External Rotation / Infraspinatus strength: RCD involving  infraspinatus
        • Cross-Body or Cross-arm Adduction: Acromioclaviculo Joint OA
        • Apprehension / Relocation / Anterior release test: Glenohumerol Instability
  • Does This Patient With Shoulder Pain Have Rotator Cuff Disease? The Rational Clinical Examination Systematic Review JAMA 2013
    Shoulder Examination (Video)
    Shoulder Pain: The Latest in Diagnosis and Care, Part 1 Medscape

The posterolateral corner of the acromion should be identified. The skin is entered one finger-breadth inferior to this with the needle directed slightly medially and cephalic to follow the undersurface of the acromion

The patient should be in a seated position with arms folded across the abdomen to open up the posterior joint space. The posterolateral corner of the acromion and the coracoid process should be identified. The easiest technique is to hold the acromion with the thumb and the coracoid with the index finger of the nondominant hand. The skin is entered 2 finger-breadths inferior to the posterolateral corner of the acromion. The needle is directed at the coracoid. If the needle strikes bone, it should be pulled back slightly, then the injection performed.