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Chronic shoulder pain: part I. Evaluation and diagnosis
Kelton M Burbank1, J Herbert Stevenson, Gregory R Czarnecki
1Longview Orthopaedic Center, HealthAlliance Hospital, Leominster, Massachusetts 01453, USA. kmbortho1@aol.com
American Family Physician
|March 11, 2008
Summary
Chronic shoulder pain lasting over six months can stem from rotator cuff disorders, adhesive capsulitis, instability, or arthritis. Diagnosis involves clinical tests and imaging like MRI for accurate rotator cuff tear and instability assessment.
Area of Science:
- Orthopedics
- Sports Medicine
- Rheumatology
Background:
- Chronic shoulder pain, persisting beyond six months, encompasses various musculoskeletal conditions.
- Common etiologies include rotator cuff disorders, adhesive capsulitis, shoulder instability, and arthritis.
Purpose of the Study:
- To review common causes of chronic shoulder pain.
- To outline diagnostic criteria and imaging modalities for these conditions.
Main Methods:
- Literature review of conditions causing chronic shoulder pain.
- Description of clinical diagnostic criteria for rotator cuff tears, adhesive capsulitis, and shoulder arthritis/instability.
- Overview of imaging techniques including plain radiographs, MRI, and ultrasonography.
Main Results:
- Rotator cuff disorders involve tendinopathy or tears, diagnosed via specific clinical tests.
- Adhesive capsulitis presents with diffuse pain and limited range of motion, potentially linked to systemic diseases.
- Osteoarthritis and instability have distinct clinical presentations and diagnostic indicators.
- Imaging is utilized when clinical diagnosis is uncertain, with MRI and ultrasound preferred for rotator cuff issues.
Conclusions:
- Accurate diagnosis of chronic shoulder pain relies on a combination of clinical evaluation and appropriate imaging.
- Understanding the specific presentation of each condition guides diagnostic and management strategies.
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