Ver el código de «Shoulder and upper arm diagnoses»

==Background==
[[File:Gray326.png|thumb|Shoulder anatomy]]
[[File:Shoulder_joint_back-en.png|thumb|Shoulder anatomy, anterior.]]
[[File:Shoulder joint back 05r4v.png|thumb|Shoulder anatomy, posterior.]]

==Differential Diagnosis==
{{Shoulder DDX}}

==Evaluation==
===Rotator Cuff Tests===
*Supraspinatus Test (+ LR 3.2)
**Abduct arm to 90', forward flex it 30' with thumb down ("empty beer can position")
**Test for pain/weakness against resistance to continued abduction
*Infraspinatus and Teres Minor Test
**Stabilize the elbow against the patient's waist and bend the elbow to 90'
**Test for pain/weakness against resistance to external rotation
*External rotation lag sign - more specific to teres minor, given overlap between infraspinatus and teres minor<ref>Collin P et al. What is the Best Clinical Test for Assessment of the Teres Minor in Massive Rotator Cuff Tears? Clin Orthop Relat Res. 2015 Sep;473(9):2959-66.</ref>
**Support the arm to 20-30 degrees in scapular plane, externally rotated, elbow flexed to 90 degrees
**Positive test is pain or difficulty in keeping the arm from internally rotating when clinician lets go
*Subscapularis (+ LR 1.9)
**Place hand behind lower back
**Test for pain/weakness as patient attempts to push examiner's hand away by moving dorsum of hand away from back
*Drop arm test
**Patient is unable to hold or smoothly lower an extended arm at 90' of shoulder abduction with out dropping it

===Impingement Tests===
*Maneuver of Neer
**Prevent scapular rotation with one hand while raising patient's straightened arm in full forward flexion to overhead
**Positive sign is pain in the arc between 70-120'
*Hawkins Impingement Test
**Position the shoulder at 90' of abduction and elbow at 90' of flexion
**Then rotate shoulder internally bringing the arm across the front of the pt
**Positive sign is pain during this maneuver

==See Also==
*[[Diagnoses by Body Part (Main)]]
*[[Shoulder x-ray interpretation]]

==References==

[[Category:Orthopedics]]
[[Category:Trauma]]
[[Category:Misc/General]]
[[Category:Symptoms]]