shoulder examination iain brown. the exam! pathology young – instability young – instability...

Shoulder Examination Shoulder Examination Iain Brown Iain Brown

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Page 1: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

Shoulder ExaminationShoulder ExaminationIain BrownIain Brown

Page 2: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

The Exam!The Exam!

Page 3: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

PathologyPathology

Young Young – Instability– Instability

Middle ageMiddle age --Frozen shoulder, Frozen shoulder, Calcific TendonitisCalcific Tendonitis

ElderlyElderlyCuff TearCuff TearOAOA

RheumatoidRheumatoid

Page 4: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

ExposureExposure

To waist ideallyTo waist ideally

Watch them undress!Watch them undress!

Must look from the backMust look from the back

Page 5: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

FeelFeel

Pain?Pain?Sternoclavicular jtSternoclavicular jtAC jointAC jointSubacromial bursaSubacromial bursaHumeral head Humeral head ScapulaScapula

Page 6: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

MovementsMovements

Look from behindLook from behind

Active and then passiveActive and then passive

Examine asymptomatic side firstExamine asymptomatic side first

Trick movementsTrick movements

Page 7: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

Forward flexionForward flexion

Extension?- view from sideExtension?- view from side

AbductionAbduction

Functional internal rotation (Gerber’s)Functional internal rotation (Gerber’s)

External rotationExternal rotation

Page 8: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

Special TestsSpecial Tests

Started with int and ext rotationStarted with int and ext rotation

Hawkin’s testHawkin’s test

Neer impingement signNeer impingement sign

Speed’s/ Yergason’s testsSpeed’s/ Yergason’s tests

Page 9: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

Instability/LaxityInstability/Laxity

Sulcus sign Sulcus sign Load shift testLoad shift testApprehensionApprehensionJobe’s relocationJobe’s relocationPosterior apprehension test Posterior apprehension test

Page 10: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

SLAP or no SLAP?SLAP or no SLAP?

O’Brien’s testO’Brien’s test

Page 11: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

Thoracic Outlet SyndromeThoracic Outlet Syndrome

Adson’s- Ext rotate, extend and abduct to Adson’s- Ext rotate, extend and abduct to hold breathhold breath

Wright’s testWright’s test

Roos test- 3 mins!Roos test- 3 mins!

Page 12: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

InvestigationsInvestigations

Page 13: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

Neck ExaminationNeck Examination

Always express eagerness to examine the Always express eagerness to examine the neck!neck!

Page 14: Shoulder Examination Iain Brown. The Exam! Pathology Young – Instability Young – Instability Middle age- Middle age- Frozen shoulder, Calcific Tendonitis

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