In collaboration with our colleagues at GPBuddy, Ms. Delaney has made the following videos explaining the diagnostic work up of shoulder problems, including history, exam and imaging. The important features of a focused clinical examination are demonstrated. In addition, the following questions are addressed:
In a patient with shoulder pain, what features are particularly useful to elicit on history?
Is imaging of the shoulder always indicated prior to orthopaedic assessment?
Is there direction on when plain film of the shoulder is indicated versus MRI of the shoulder?
Can you discuss the indications for referral of shoulder problems to orthopaedic surgery?
When creating a referral letter to a shoulder orthopaedic specialist, what information is particularly useful to include?
"With the shoulder exam, it's easy to get bogged down in too many special tests and complicated examination manoeuvres, but in reality it's best to keep it simple. If we can figure out whether or not a shoulder is stiff and whether or not a shoulder is weak, then that will guide much of the rest of the work up. Watch the exam section of the video below to see how I examine shoulders every day in my clinic. In some special circumstances, I may add one or two more specific tests, but in the vast majority of cases, the exam you see here is what I use." - RD.