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Related Experiment Videos

Shoulder pain: a diagnostic dilemma

S M Glockner1

  • 1University of California-San Diego family practice residency program, USA.

American Family Physician
|May 15, 1995
PubMed
Summary

Understanding shoulder pain involves five main causes, including fractures, instability, and impingement. Ruling out other conditions and using physical exams helps diagnose the source of shoulder discomfort.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Physical Therapy

Background:

  • Shoulder pain is a common complaint with diverse etiologies.
  • Accurate diagnosis is crucial for effective treatment of shoulder conditions.
  • Differential diagnosis must exclude non-musculoskeletal causes of shoulder pain.

Purpose of the Study:

  • To outline the primary categories of shoulder pain etiology.
  • To emphasize the importance of a thorough differential diagnosis for shoulder pain.
  • To guide the appropriate use of diagnostic imaging in shoulder pain evaluation.

Main Methods:

  • Categorization of shoulder pain causes into five main groups.
  • Exclusion of non-shoulder pathologies (e.g., cervical strain, referred pain).
  • Emphasis on patient history (trauma vs. overuse) and physical examination findings.

Main Results:

  • Five primary categories for shoulder pain etiology identified: fracture/contusion, clavicle separation, glenohumeral instability, impingement syndrome/tendinitis, and frozen shoulder.
  • History and physical examination are key initial diagnostic tools.
  • Radiographic studies are indicated for trauma; advanced imaging (MRI, arthrograms) reserved for non-responders to conservative treatment.

Conclusions:

  • A systematic approach to evaluating shoulder pain is essential.
  • Conservative treatment should be attempted before advanced imaging for overuse injuries.
  • Timely and accurate diagnosis leads to appropriate management of shoulder pain.

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