Shoulder examination

Question 1

look

Answer 1

Anterior:
- Contour of the shoulder
- Deltoid and trapezius muscle bulk
- Sterno-clavicular and acromio-clavicular joints for deformity
- Clavicle for deformity
- Scars

Laterally:
- Shoulder contour
- Sterno-clavicular and acromio-clavicular joints

Posteriorly:
- Supraspinatus and infraspinatus fossae for muscle wasting
- Scapula for evidence of asymmetry

Axilla:
- Swellings
- Scars

Question 2

feel

Answer 2

one side only

Sterno-clavicular joint and clavicle Acromio-clavicular joint and acromion Long head of biceps
Scapula (spine and body)

Question 3

move

Answer 3

Compare both shoulders

External rotation
Forward flexion
Abduction
Internal rotation (record as vertebral level reached by hand) Scapula winging*

Question 4

rotator cuff tests

Answer 4

Rotator cuff and/or ACJ pathology:
- Painful arc on abduction (impingement)
- Hawkins-Kennedy test (impingement)
- Scarf test (ACJ pathology)
- Rotator cuff tear – test power of supraspinatus (Jobe’s test),
infraspinatus and subscapularis

Question 5

instability tests

Answer 5

Suspected instability:
- Sulcus sign
- Anterior and posterior drawer tests
- Anterior apprehension and relocation test
- Posterior apprehension test*