Clinical guide

 

Impingement

Has there been a fall/ accident?

no, next

 


 
Can the patient lift their arm above their head?

yes, next

 


 
Is there pain in the middle of the movement?

 

yes, next


 
Holding arm out in front, with thumb down, push up against physio’s hands. Is it painful?

 

yes, next


 
Hold arm up at 90° flexion with elbow bent. Internally rotate. Is it painful?

 

yes

  yes Impingement

 


Rotator cuff tear

Has there been a fall/ accident?

no, next

 


 
Can the patient lift their arm above their head?

 

no, next


 
Is the patient between 45-55 years old?

 

no, next


 
Can the patient move their arm as far as possible, even if painful, without help?

 

no, next


 
Put hand behind back. Can the patient lift hand away from body?

 

no, next


 
Can you lift the arm further than the patient can lift it?

 

yes

  next Rotator cuff tear

Shoulder osteoarthritis

Has there been a fall/ accident?

no, next

 


 
Can the patient lift their arm above their head?

yes, next

 


 
Is there pain in the middle of the movement?

no, next

 


 
Lift arm across body. is it painful?

 

yes, next


 
Is the patient older than 60 years?

yes, next

 


 
Is it painful to touch the edge of the bony tip of the shoulder?

 

yes

  nextShoulder osteoarthritis

Frozen shoulder

Has there been a fall/ accident?

no, next

 


 
Can the patient lift their arm above their head?

 

no, next


 
Is the patient between 45-55 years old?

yes, next

 


 
Is there a loss of external rotation?

 

yes

  nextFrozen shoulder

 

A/C joint dislocation

Has there been a fall/ accident?

 

yes, next


 
Is there an obvious step down deformity at the edge of the shoulder?

 

yes, next


 
Touch edge of shoulder. Is it painful to feel corner of shoulder?

 

yes, next


 
Lift arm across body. Is it painful?

 

yes

  nextA/C joint dislocation

Shoulder dislocation

Has there been a fall/ accident?

 

yes, next


 
Is there an obvious step down deformity at the edge of the shoulder?

no, next

 


 
Is the ball of the shoulder joint positioned more to the front of the chest?

 

yes, next


 
Can the patient lift their arm up?

 

no

  nextShoulder dislocation

Shoulder fracture

Has there been a fall/ accident?

 

yes, next


 
Is there an obvious step down deformity at the edge of the shoulder?

no, next

 


 
Is the ball of the shoulder joint positioned more to the front of the chest?

no, next

 


 
Feel along upper arm and around shoulder blade. Is it painful?

 

yes

  nextShoulder fracture