Question

What is the organized physical examination that follows the orthopedic examination outline?

5. A 40 year old left hand dominant male presents for evaluation of a 2 day history of
severe pain and weakness in his left shoulder. He is a tennis player and notes that 2 days ago
he was serving and felt a “pop” in his left shoulder. Since then, he has been unable to raise his
arm above his head. He has rested it, iced it and taken Aleve and Tylenol for his pain. He notes
a history of trouble with his left shoulder but “nothing like this.” His pain is 7/10 with motion and
an achy intermittent pain at rest. He is unable to lie on that side at night when he sleeps. He
denies any pain radiating into his hand nor any numbness or tingling. No significant past
medical history.

Answer 1

The shoulder region should be inspected initially for the inflammation,signs like swelling and tenderness..
Procedures:
Palpation should be done for the following region of the shoulder
- sternoclavicular joint
- clavicular AC joint and acromion
- coracoid process, bicipital groove
- lesser and greater tubercle
- palpation of the scapula
Shoulder mobility testing indication of potential pathological conditions..
Detailed examination and special test like
Apley scratch test
Range of motion of the shoulder includes
- glenohumeral joint with specific rotation with isolated
- glenohumeral joint with shoulder girdle involvement with specific rotation
Examination of the rotator cuff to find out supraspinatus muscle disorder
Examination of the suprascapularis muscle to findout disorder in suprascapularis tendon..it include belly press test - positive test indicate disorder of the subscapularis tendon with different degree..
Examination of the infraspinatus muscle and teres minor muscle positive test indicate suprascapular nerve lesion.
Examination of the long head of the biceps tendon it include palm up test,positive result indicate glenoid labrum lesion.
Speed's test, O' Brien's test positive test indicate SLAP lesion.
Yergason test positive result indicate biceps tendon inflammation..
shoulder impingement test,it include painful arc test, neer test, Hawkins - kennedy test, anterior and posterior drawer test,sulcus sign..
shoulder apprehension test(anterior and posterior) positive test indicate capsulo ligamentous complex lesions.
Relocation test used to findout anterior shoulder instability..