My husband hurt his shoulder and it was finally diagnosed as a subacromial impingement. He had had x-rays and stuff done, but the doctor diagnosed him after he examined my husband and had him move his shoulder around. Why was this not seen on the x-rays?

Not all injuries or problems involving the shoulder (or other joints) can be seen on x-rays. X-rays show the bones and some of the body structure, but not everything. In cases such as your husband's, the x-rays are good for ruling out other medical problems that could have been causing pain, such as a fracture or a dislocation.

Reference: 

Lori A. Michener, PhD, PT, ATC, et al. Reliability and Diagnostic Accuracy of 5 Physical Examination Tests and Combination of Tests for Subacromial Impingement. In Archives of Physical Medicine and Rehabilitation. November 2009. Vol. 90. Pp. 1898 to 1903.

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