Examination of the shoulder
Meet the speakers Dr Dr Da Dann nny y Mur urph phy Johan Holte Staff grade rheumatologist and GP Consultant Physiotherapist
Learning outcomes 1. Gain confidence in taking an effective history from an MSK patient, including eliciting red flags and psychosocial flags. 2. Be able to demonstrate focused examination of the MSK patient. 3. Practice explanation of the diagnosis. 4. Formulate a management plan, including appropriate investigations, referral, safety net and follow-up.
The MSK examination Use basic anatomy It’s not about and think about the remembering lots structures you are of special tests! examining How many Keep things ‘special tests’ are simple and structured – five described for the golden rules shoulder? 129
Shoulder examination • Introduction and anatomy • Where’s the pain coming from? • Examination demonstration and practice
The sub-acromial space and bursa
Que Question stion: : Wha hat c t cou ould this ld this be be? A. Is it red flag pain? B. Is it traumatic? C. Is this rotator cuff pain? D. Is this glenohumeral pain? E. Is this pain from outside of the shoulder?
Matrix for examination of the shoulder and neck Test Feel Clear the Look Move neck • • • • Empty can Tender Scars Active ER • • test points • Wasting Active IR Look • • • • ACJ Asymmetry FF in neutral Feel • • Winging then in IR Move • ‘Foraminal (painful arc) • closure test’ ABD (painful arc)
Exercises
Core skills Workshops Remaining workshop dates for 2019: Wednesday 23 October – Leeds Tuesday 26 November – London Tuesday 10 December – Glasgow To book your place visit: www.coreskillsinmsk.co.uk For local workshops in your areas please contact Versus Arthritis on stand K92 For free educational resources join the Versus Arthritis professional network: Visit https://www.versusarthritis.org/about-arthritis/healthcare- professionals/
Thank you… Questions?
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