Shoulder exam

Question 1

Intro

Answer 1

Intro self, identity and consent. Ask if they want a chaperone as you will need to expose back. Ask if any pain

Question 2

Questions to ask patient

Answer 2

Can you wash your hair comfortably?

Can you dress comfortably?

Question 3

Inspection

Answer 3

Look - front side and back
- Walking aids, slings, scars, bony prominences, muscle wasting and winged scapula

Question 4

Feel

Answer 4

Temperature over shoulder area

Joint lines - shoulder, clavicle, acromioclavicular, coracoid, humerus,

Muscle bulk - deltoid, supraspinatus, infraspinatus, trapezius

Question 5

Screening movements

Answer 5

Arms behind head and push back

Arms behind back and reach up as far as they can

Question 6

Active movements

Answer 6

Flex elbow and rotate inwards and outwards

Raise arms in front and behind you

arms out to the side as far as possible and then cross over the body

Question 7

Passive movements

Answer 7

Bring patients arm to ceiling then ask them to bring it slowly down in an arc and look for pain

Passive external and internal roation, passive flexion and extension and abduction

Question 8

Resisted movements

Answer 8

Empty a can and then resist this

Lift off - place hands behind back and push up towards my hands

Scarf test - get patient to place their hand on opposite shoulder and then push their elbow up

Question 9

Present for shoulder

Answer 9

Today I performed a shoulder examination of patient X. on general inpsection they appeared comfortable at rest with no obvious signs of pathology. On palpation their was no tenderness or crepitus and there was a full range of motion across all modalities tested. All special tests were negative. Overall this was a normal shoulder examination. To complete this exam I would also perform an examination of the C spine and elbow