Summary

Shoulder dysfunction often stems from issues with the shoulder capsule, such as being overly tight or too loose, or from damage or fatigue in the rotator cuff musculotendinous unit. Less frequently, it can result from damage to the articular cartilage of the glenohumeral or acromioclavicular joint. In cases of AC joint pain, it’s notable for its localised pain. Diagnostics for shoulder issues include testing for external rotation motion to confirm stiffness and the apprehension test for looseness. Assessing the power of external rotation and supraspinatus, along with checking for impingement signs, are critical for evaluating rotator cuff function.

 

For diagnostic imaging, X-rays are highly valuable in identifying conditions such as calcific tendonitis, glenohumeral joint arthritis, and cuff-tear arthropathy, while ultrasound is a key tool in confirming rotator cuff tears. Treatment approaches can vary; a single corticosteroid injection is often a first-line treatment for AC joint pain and impingement. For more persistent conditions like impingement, instability, stiffness, and numerous rotator cuff tears, minimally invasive arthroscopic surgery can be highly effective. In cases of severe gleno-humeral joint arthritis, shoulder replacement surgery is considered an effective treatment option.

 

For further information or questions, please contact us directly at our Sydney clinic – George Murrell Shoulders.

References

 

Bhargav D, Murrell GAC: Shoulder stiffness: diagnosis. Aust Family Physician 33: 143-7, 2004

 

Bhargav D, Murrell GAC: Shoulder stiffness: management. Aust Family Physician 33: 149-52, 2004

 

Bryant L, Shnier R, Bryant C, Murrell GAC: A comparison of clinical estimation, ultrasonography, magnetic resonance imaging, and arthroscopy in determining the size of rotator cuff tears. J Shoulder Elbow Surg 11: 219-24, 2002

 

Itoi E, Hatakeyama Y, Kido T, Sato T, Minagawa H, Wakabayashi I, Kobayashi M: A new method of immobilization after traumatic anterior dislocation of the shoulder: A preliminary study. J Shoulder Elbow Surg 12: 413-5, 2003

 

Jobe FW, Kvitne RS, Giangarra CE: Shoulder pain in the overhand or throwing athlete. The relationship of anterior instability and rotator cuff impingement [published erratum appears in Orthop Rev 1989 Dec;18(12):1268]. Orthop Rev 18: 963-75, 1989

 

Murrell GAC: Treatment of shoulder dislocation: is a sling appropriate? Medical Journal of Australia 179: 370-1, 2003

 

Murrell GAC, Bhargav D: Medical and surgical manipulation of the shoulder capsule and labrum. APLAR J Rheum 2: 247-52, 1999

 

Murrell GAC, Walton J: Diagnosis of rotator cuff tears. Lancet 357: 769-70, 2001

 

O’Brien SJ, Pagnani MJ, Fealy S, McGlynn SR, Wilson JB: The active compression test: a new and effective test for diagnosing labral tears and acromioclavicular joint abnormality. Am J Sports Med 2: 610-43, 1999

 

Paxinos A, Rutten S, Walton JR, Murrell GAC. Temporal outcomes of arthroscopic stabilization of superior labral (SLAP) tears with biodredable tac. in 27th Annual Meeting American Orthopaedic Society for Sports Medicine. 2001. Keystone, Colarado.: pp

 

Silliman JF, Hawkins RJ: Current concepts and recent advances in the athlete’s shoulder. Clin Sports Med 10: 693-705, 1991

 

Tzannes A, Murrell GAC: Clinical examination of the unstable shoulder. Sports Medicine 32: 1-11, 2002

 

Tzannes A, Paxinos A, Callanan M, Murrell GAC: An assessment of the inter-examiner reliability of tests for shoulder instability. J Shoulder Elbow Surg 13: 18-23, 2004

 

Walton J, Paxinos A, Mahajan S, Marshall J, Bryant C, Shnier R, Quinn R, Murrell GAC: Diagnostic values of tests for acromioclavicular joint pain. J Bone Joint Surgery (Am) 86: 807-12, 2004

 

Walton J, Paxinos A, Tzannes A, Callanan M, Hayes K, Murrell GAC: The unstable shoulder in the adolescent athlete. Am J Sports Med 30: 758-67, 2002

 

Walton J, Tzannes A, Murrell GAC. The predictive value of clinical tests for shoulder instability. in 47th Annual Meeting Orthopaedic Research Society. 2001. San Francisco: Orthopaedic Research Society, pp 0288

 

Yuan J, Murrell GAC, Wei A-Q, Wang M-X: Apoptosis in rotator cuff tendonopathy. J Orthop Res 20: 1372-9, 2002