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Impingement syndrome can be diagnosed by a targeted medical history and physical examination, [11] [12] but it has also been argued that at least medical imaging [13] (generally X-ray initially) and/or response to local anesthetic injection [14] is necessary for workup. However, imaging studies are unable to show cause of shoulder pain in ...
With 120 degrees of unassisted flexion, the shoulder joint is the most mobile joint in the body. Animation of the shoulder joint. The muscles shown are subscapularis muscle (at right), infraspinatus muscle (at top left), teres minor muscle (at bottom left)
Medical history (the patient tells the doctor about an injury). For shoulder problems the medical history includes the patient's age, dominant hand, if injury affects normal work/activities as well as details on the actual shoulder problem including acute versus chronic and the presence of shoulder catching, instability, locking, pain, paresthesias (burning sensation), stiffness, swelling, and ...
The shoulder joint is made up of three bones: the shoulder blade (scapula), the collarbone (clavicle) and the upper arm bone (humerus). The acromion is a bony process at the end of the scapula The shoulder is a complex mechanism involving bones, ligaments , joints , muscles , and tendons .
The infraspinatus and supraspinatus [13] tests have a specificity of 80% to 90%. [10] A common cause of shoulder pain in rotator cuff impingement syndrome is tendinosis, which is an age-related and most often self-limiting condition. [14]
The infraspinatus is the main external rotator of the shoulder. When the arm is fixed, it adducts the inferior angle of the scapula. Its synergists are teres minor and the deltoid. [4] The infraspinatus and teres minor rotate the head of the humerus outward (external, or lateral, rotation); they also assist in carrying the arm backward. [1]
The tests differ in the rotation of the arm; in the empty can test, the arm is rotated to full internal rotation (thumb down) and in the full can test, the arm is rotated to 45° external rotation, thumb up. [1] Once rotated, the clinician pushes down on either the wrists or the elbow, and the patient is instructed to resist the downward pressure.
A meta-analysis in 2008 concluded that the diagnostic accuracy of individual tests in the shoulder examination was limited, specifically that the Hawkins–Kennedy test and the Speed test have no discriminatory ability to diagnose specific shoulder pathology, and that results of studies evaluating other tests were too statistically ...