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Arthrography of shoulder joint (with or without computed tomography) is performed by injecting contrast below and lateral to the coracoid process to outline the shoulder joint. Axillary pouch of the shoulder can be seen on external rotation, while subscapular (subcoracoid) bursa can be seen on internal rotation of arm.
It is also widely available, convenient, and cost efficient. Thickening in the coracohumeral ligament, inferior capsule/ axillary recess capsule, and rotator interval abnormality, as well as restriction in range of motion in the shoulder can be detected using ultrasound. The range of motion is prohibited due to scapulohumeral rhythm changes ...
Hawkins–Kennedy test: a positive test indicates shoulder impingement syndrome; Empty beer can test: a positive test indicates rotator cuff tear, specifically, supraspinatus muscle tear; Drop arm test: a positive test indicates a supraspinatus tear; External Rotation test: a positive test indicates an infraspinatus or teres minor tear
The shoulder joint involves articulation between the glenoid cavity of the scapula (shoulder blade) and the head of the upper arm bone and functions as a diarthrosis and multiaxial joint. Due to the very loose joint capsule that gives a limited interface of the humerus and scapula, it is the most mobile joint of the human body.
In both tests, the patient is placed in a standing or sitting position, and the arms are raised parallel to the ground in the scapular plane. [2] 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]
A variety of methods may be used to diagnose axillary nerve palsy. The health practitioner may examine the shoulder for muscle atrophy of the deltoid muscle. [2] Furthermore, a patient can also be tested for weakness when asked to raise the arm. [2] The deltoid extension lag sign test is one way to evaluate the severity of the muscle weakness.
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However, imaging studies are unable to show cause of shoulder pain in diagnosing. For example, MRI imaging would show rotator cuff pathology and bursitis but is unable to specify the cause. [15] On physical exam, the physician may twist or elevate the patient's arm to test for reproducible pain (the Neer sign and Hawkins-Kennedy test).