Upper Extremity Surgeon's Guide to the Evaluation of the Shoulder Girdle and Diagnosis of Associated Pathology

Shoulder injuries can pose as a diagnostic challenge for clinicians. Owing to the wide variety of pathologies and the fact that they frequently coexist, diagnosis can be difficult. Accurate diagnosis and management not only require a thorough understanding of each condition but the ability to narrow down the broad differential through detailed physical examination. This review article provides an in-depth examination of common shoulder conditions and outlines key physical examination techniques for upper extremity surgeons and other clinicians who manage these conditions. It begins by providing an up-to-date overview of the various pathologies that affect the shoulder girdle, including rotator cuff tears, quadrangular space syndrome, labral instability and glenohumeral bone loss, adhesive capsulitis, superior labral and biceps pathology, thoracic outlet syndrome, acromioclavicular joint degeneration, and glenohumeral osteoarthritis. This review then discusses key physical examination aspects, such as the history of present illness, cervical spine evaluation, range of motion assessment, strength testing, and shoulder girdle-specific maneuvers. This comprehensive review highlights the importance of a thorough understanding of shoulder physical examination and special diagnostic tests, emphasizing history-taking and examination to ensure diagnostic accuracy and optimize patient outcomes for surgeons.