In the name of GOD. Sheikhlotfolah mosque Isfahan. Shoulder &Upper arm Physical Examination. Babak Vahdatpour MD Assi stant professor Department of Physical Medicine & Rehab. Isfahan University of Medical Sciences . DDx. of Shoulder Pain or reduced R.O.M. Rotator Cuff Dis.
Department of Physical Medicine & Rehab.
Isfahan University of Medical Sciences
Swollen subacromial bursa in R.A Rupture of the left pectoralis major tendon.
Fractured left clavicle. Swollen sternoclavicular joint due to a fracture of the medial end of the left clavicle
of the biceps tendon (arrow).
1.subacromial space → rotator cuff tendinitis impingement syndrome calcific tendinitis rotator cuff tear2.bicipital groove → bicipital tendinitis bicipital tendon subluxation, tear
4.anterior glenohumeral joint → glenohumoral arthritis osteonecrosis glenoid labrum tear
adhesive capsulitis 5.sternoclavicular joint
6.posterior edge of acromion → rotator cuff tendinitis calcific tendinitis rotator cuff tear
7.suprascapular notch → suprascapular nerve entrapment
8.Quadrilateral space → axillary nerve entrapment
C, Internal rotation.
FIGURE 3. Supraspinatus examination ("empty can" test). The patient attempts to elevate the arms against resistance while the elbows are extended, the arms are abducted and the thumbs are pointing downward.
FIGURE 4. Infraspinatus/teres minor examination. The patient attempts to externally rotate the arms against resistance while the arms are at the sides and the elbows are flexed to 90 degrees
FIGURE 5. Neer's test for impingement of the rotator cuff tendons under the coracoacromial arch. The arm is fully pronated and placed in forced flexion.
FIGURE 6. Hawkins' test for subacromial impingement or rotator cuff tendonitis. The arm is forward elevated to 90 degrees, then forcibly internally rotated.
A.C joint or labrum injury
FIGURE 7. Cross-arm test for acromioclavicular joint disorder. The patient elevates the affected arm to 90 degrees, then actively adducts it.
FIGURE 8. Apprehension test for anterior instability. The patient's arm is abducted to 90 degrees while the examiner externally rotates the arm and applies anterior pressure to the humerus.
FIGURE 10. Sulcus test for glenohumeral instability. Downward traction is applied to the humerus, and the examiner watches for a depression lateral or inferior to the acromion.
FIGURE 9. Yergason test for biceps tendon instability or tendonitis. The patient's elbow is flexed to 90 degrees, and the examiner resists the patient's active attempts to supinate the arm and flex the elbow.