12 Clinical Examination Look Feel Move!!! Range of movement. Deltoid function.Tests for Supraspinatus function.Tests for Infraspinatus / Teres minor function.Tests for subscapularis function.Tests for Biceps TendonTests for ACJ and Superior labrum.
26 Investigations – X-Rays Frozen Shoulder To exclude other pathologyRotator cuff diseaseImpingement Sclerosis GT and AcromionCuff tear Superior migration of humerus(+/-)Cuff arthropathy Humero-acromial articulationInstability Hill Sachs lesionGlenohumeral OA DiagnosisACJ dislocation/OA Diagnosis
40 When to Refer to a Shoulder Specialist Impingement not responding to conservative measuresFrozen shoulder not showing any improvement despite physiotherapy for 6 monthsSuspected Rotator cuff tear.Cuff tear arthropathyInstability / SLAP lesionsOsteoarthritis / Rheumatoid ArthritisUncertainty of diagnosis.Red flag signs
41 Infection : red hot skin, pyrexial, systemically unwell Unreduced dislocation: h/o trauma/fit/electric shock, abnormal contour, loss of movementsAcute rotator cuff tear: acute onset pain and weakness, recent trauma, drop arm signTumour: S/S of cancer, h/o cancer, abnormal mass, swelling or deformityNeurological: severe sensori-motor deficit, unexplained muscle wasting.