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6 Αυγ 2021 · elbow flexed to 90 degrees with the forearm pronated. The examiner holds the hand/wrist to maintain pronated position while the patient attempts to actively supinate against this resistance. If there is pain located along the bicipital groove the test is positive for biceps tendon pathology.
Conducting a proper shoulder exam is crucial to treating shoulder pain, a common outpatient complaint. No matter the cause, it is important to be familiar with some basic examination tools that can help us confirm the presence of a shoulder lesion.
Shoulder Examination. Lift off test: Subscapularis. The prerequisite for any treatment in the shoulder region of a patient with pain is a precise and comprehensive picture of the signs and symptoms as they occur during the assessment and as they existed until then.
Look out for a painful arc (i.e. pain between 60-120 degrees of shoulder elevation) or if pain is only present at the end range. Consider the following questions: where is the pain located?
• Hawkin's test: Shoulder flexed 90º, elbow flexed 90o; internal rotation will cause pain. • Neer's test: Pain eliminated by local anaesthetic injection into the subacromial bursa. • Copeland Impingement Test: Passive abduction in internal rotation (in the scapula
Review the exam skills and concepts needed in the typical internal medicine patient population. Review shoulder anatomy, landmarks and main diagnostic considerations. Provide an approach to the shoulder exam with an emphasis on evaluation of: Rotator cuff tear vs. mechanical impingement.
O’ Brien’s Test. Adduction 15-20 deg. Forward Flexion 90 deg. Thumbs down. Resisted forward flexion. Positive test only when: Pain with the above position. Pain diminishes when palm is supinated. Otherwise equivocal test.
