Shoulder Objective assessment

         
        bjective assessment

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Keep your Objective Notes going as you proceed with the following assessment

Quick medical check

HIV
nocturnal pain/ drop attacks/
speaking/ swallowing problem
dizziness
cancer/ inflammatory arthritis
TB
weight loss/ fevers
less than 20/ more than 55
double vision
severe pain
spinal cord compression
significant vertebral tenderness
shoulder trauma/ surgery
preceding trauma or shoulder surgery
bladder/bowel incontinence
loss of feeling in both legs

Please seek medical help if any of the above apply or else confirm that you have checked that none do.


Has there been a recent accident or fall?


Does the patient usually sit with a slouched posture?


Can the patient lift their arm above their head even with pain?


Is there pain in the middle of the movement?


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


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


Lift arm across body, is it painful?


Is the patient older than 60 years?


Is it painful to touch around the joint, and morning stiffness felt on movement?


Is the patient between 40-55 years and has good strength with resistance tests?


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


Putting hand behind patient's back, can they lift hand away from body?


Is there a positive external lag test?


Is there a loss of external rotation?


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


Touching the edge of the shoulder, is it painful to feel corner?


Lift arm across body. Is it painful?


Lift arm across body. Is it painful?


Can the patient lift their arm up?


Tap on the bone of the arm away from the site of pain. Is it painful locally and sore when tapped away from site of pain, and bruising present?

Objective assessments (print-out version)

1: Has there been a recent accident or fall?

3 yes 15

2: Does the patient usually sit with a slouched posture?

4 yes 3

3: Can the patient lift their arm above their head even with pain?

4 yes 10

4: Is there pain in the middle of the movement?

7 yes 5

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

7 yes 6

6: Hold arm up at 90° flexion with elbow bent and rotate internally. Is it painful?

7 yes yes Impingement

7: Lift arm across body, is it painful?

11 yes 8

8: Is the patient older than 60 years?

9 yes 14

9: Is it painful to touch around the joint, and morning stiffness felt on movement?

11 yes yes Shoulder OA

10: Is the patient between 40-55 years and has good strength with resistance tests?

14 yes 11

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

14 yes 12

12: Putting hand behind patient's back, can they lift hand away from body?

14 yes 13

13: Is there a positive external lag test?

14 yes yes
Rotator cuff tear

14: Is there a loss of external rotation?

END yes yes
Frozen shoulder

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

18 yes 16

16: Touching the edge of the shoulder, is it painful to feel corner?

18 yes 17

17: Lift arm across body. Is it painful?

18 yes yes
A/C joint dislocation

18: Lift arm across body. Is it painful?

20 yes 19

19: Can the patient lift their arm up?

20 yes yes
Shoulder dislocation

20: Tap on the bone of the arm away from the site of pain. Is it painful locally and sore when tapped away from site of pain, and bruising present?

END yes yes
Shoulder fracture