Review of the Shoulder: Evaluation and Diagnosis

In this article doctors from The Johns Hopkins University review the complexities of the shoulder. Diagnosis can be very difficult since there are so many parts to the joint. Many tests show there's a problem in the shoulder but not what the problem is.

The authors present a step-by-step way for the physician to examine the shoulder. The importance of patient history and the way symptoms begin are pointed out. They go over the exam basics for a rotator cuff problem. They also review nerve or neurologic conditions and acromioclavicular (AC) joint problems.

The AC joint is in front of the shoulder where the collarbone meets the acromion. The acromion is a bridge of bone coming from the back of the shoulder blade, curving over the top of the shoulder. They also compare symptoms and test results for rotator cuff problems with a stiff shoulder.

Many patients have more than one problem causing shoulder pain, loss of motion, or weakness. Pain patterns and symptoms can be the same for various conditions. A thorough evaluation is needed to make the diagnosis and to plan treatment. This article helps physicians sort out causes of shoulder pathology.