12 - Clinical examination of the shoulder

Clinical examination of the shoulder 12. CHAPTER CONTENTS First, it should be realized that double lesions do exist, Referred pain .. 208 clouding the diagnosis. For example, it is not uncommon to find supraspinatus tendinosis together with infraspinatus tendi- Pain referred to the shoulder .. 208 nosis or in association with subdeltoid bursitis. In these doubt- Pain referred from the shoulder .. 208 ful cases, a diagnostic infiltration of a local anaesthetic can be History .. 209 most helpful in isolating the second lesion. On other occasions, patients present with a painful limita- Inspection .. 209. tion of passive movement together with pain on resisted Functional examination .

vicular joint, which is of C4 origin (Fig. 12.1). In acromiocla-vicular joint problems the pain is felt at the tip of the shoulder, with little spread. Exceptionally, when the lesion lies at the inferior acromioclavicular ligament, the pain can spread into the upper arm. In a lesion of one of the other shoulder structures, such as

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  Clinical, Examination, Shoulder, Joint, Of the shoulder, Clinical examination of the shoulder

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