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[Examination of the shoulder].

Tjeerd O H de Jongh1, G M Rommers, Rienk Dekker

  • 1Leids Universitair Medisch Centrum, afd. Public Health en Eerstelijnsgeneeskunde, Leiden, The Netherlands. tohdejongh@telfort.nl

Nederlands Tijdschrift Voor Geneeskunde
|March 31, 2011
PubMed
Summary

Assessing shoulder joint range of motion is crucial for diagnosing shoulder disorders. Reliable tests for abduction and external rotation can identify specific pathologies, unlike other less dependable shoulder tests.

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Area of Science:

  • Orthopedics and Sports Medicine
  • Musculoskeletal System Examination

Background:

  • Diagnosing shoulder disorders relies heavily on evaluating the shoulder joint's range of motion.
  • Specific movements, like abduction and external rotation, are key indicators of underlying pathologies.

Purpose of the Study:

  • To determine the diagnostic value of active and passive range of motion tests for shoulder disorders.
  • To assess the reliability of specific shoulder movement tests in clinical diagnosis.

Main Methods:

  • Examination of active and passive range of motion, focusing on abduction and external rotation.
  • Evaluation of the reliability of shoulder joint movement tests.
  • Assessment of palpation's utility in conjunction with inspection and range of motion.

Main Results:

  • Abduction and external rotation range of motion tests demonstrate reliable assessment.
  • Limitations in abduction indicate subacromial pathology; limitations in external rotation suggest glenohumeral pathology.
  • Other shoulder joint movement tests exhibit low inter-rater reliability; palpation offers limited value if initial assessments are normal.

Conclusions:

  • Active and passive range of motion, particularly abduction and external rotation, are reliable diagnostic tools for shoulder disorders.
  • The diagnostic value of impingement and stability tests requires further reliable demonstration.
  • Clinical examination should prioritize reliable range of motion assessments over less dependable tests.