Clinical examination of the shoulder joint

Look:

• scars and sinuses
• shoulder assymmetry, muscle wasting, winging, swelling
• position of the arm, ie held internally rotated as in posterior shoulder dislocation

Feel:

• tenderness, crepitus
• bony tenderness

Move - compare both sides:

• active and full abduction: initiation, range, rhythm - note the arc of painful movement
• active adduction, flexion, extension, internal and external rotation.
• Test glenohumeral abduction passively, by pressing down and fixing the scapula with one hand and moving the arm with the other.
• test complex movements by asking the patient to touch the back of their opposite shoulder with their arm in front, then behind them, then ask them to place their hands on the back of their neck.
• test deltoid and pectoralis major power and also for winging of the scapula.

Click here for video of shoulder examination