1. Shoulder Examination
Iain Brown

2. The Exam!
All here to paas the exam. Have to be automatic. Waiting in the area for quite dome time. Dry mouth and nervous. When faced with that patient in first station what are you going to do?
All about how you instruct the patient using appropriate language. You have to try this out in the clinics. Tomorrow! Talk to the patient.

3. Pathology Young – Instability Middle age - Frozen shoulder,
Calcific Tendonitis
Elderly
Cuff Tear OA
Rheumatoid

4. Exposure To waist ideally Watch them undress! Must look from the back
Deformity and contours
Scars
Wasting go on to palpation

5. Feel Pain? Sternoclavicular jt AC joint Subacromial bursa Humeral head
Scapula
Feel muscle wasting. Palpable swellings. Prominent coracoid- post dislocation

6. Movements Look from behind Active and then passive
Examine asymptomatic side first
Trick movements

7. Forward flexion
Extension?- view from side
Abduction
Functional internal rotation (Gerber’s)
External rotation

8. Special Tests Started with int and ext rotation Hawkin’s test
Neer impingement sign
Speed’s/ Yergason’s tests
Speed’s abducted, yergason’s arm is pronated and elbow 90 degrees

9. Instability/Laxity Sulcus sign Load shift test Apprehension
Jobe’s relocation
Posterior apprehension test

10. SLAP or no SLAP?
O’Brien’s test

11. Thoracic Outlet Syndrome
Adson’s- Ext rotate, extend and abduct to hold breath
Wright’s test
Roos test- 3 mins!

12. Investigations

13. Neck Examination
Always express eagerness to examine the neck!

14. Recommended Reading Oswestry Orthopaedic Clinical Examination
Shoulderdoc.co.uk