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Urgent referral
Swelling increasing in size - exclude tumour
Fever with swollen / painful joint - exclude infection
Loss of shoulder motion after injury to shoulder - exclude rotator cuff tear
Sudden severe shoulder pain - exclude calcific tendinitis
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Age
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Symptoms (complaints)
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Signs (physical findings)
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Diagnosis
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25 - 70
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Neck pain & stiffness
Pain base of neck / shoulder blade
Pain radiating down the entire arm
Tingling / numbness in arm, forearm & fingers
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Neck stiff
Neck movements reproduce symptoms
Neurological signs in arm
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Neck pathology
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35 - 75
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Pain upper arm / lateral to acromiom
Night pain
Difficulty using arm above shoulder height
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35 - 75
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Pain upper arm / lateral to acromiom
Night pain
Difficulty using arm above shoulder height
History of fall
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Weakness on abduction of arm
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30 - 50
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Pain front of shoulder
Difficulty sleeping on affected side
Difficulty using arm above shoulder height
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Tender / bump over AC joint
Pain when arm is moved across the body
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40 - 60
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Pain front of shoulder
Severe pain
Shoulder stiffness
History of diabetes / thyroid problems
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60 onwards
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Pain front of shoulder
Severe pain
Shoulder stiffness
Grating / creaking noises from shoulder
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10 - 35
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History of shoulder dislocation
Feeling of instability
Shoulder pops / slips out of joint
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Apprehension with shoulder in external rotation & abduction
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20 - 40
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History of traction injury to shoulder / throwing or overhead motions of shoulder
Popping / snapping of shoulder
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Reproducing anterior shoulder pain when resistance applied to forearm held at shoulder height
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Any age
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History of surgery / injury to the posterior triangle of neck
Fascioscapulohumeral dystrophy
Swimmers
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Prominence of medial border of scapula when patient pushes with outstretched hand against a wall
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Opinions expressed are those of the author Sunil Sharma and are intended to be used as a simple aid to help patients understand more about the conditions and treatments described. Patients should always consult a qualified doctor regarding diagnosis and treatment of medical conditions.
