The document outlines the process for examining a patient's shoulder, including inspection, feeling for tenderness and temperature, assessing range of motion actively and passively, and performing special tests. Key steps are introducing yourself to the patient, gaining consent, exposing the joint, systematically examining alignment, skin, muscles, and bones. A variety of special tests are described to check for impingement, rotator cuff pathology, instability, biceps issues, AC joint problems, and thoracic outlet syndrome. The exam is completed by examining adjacent joints and neurovascular status.

1. Clinical Shoulder
- OSCE
Dr. Abdullah K. Ghafour
4th year IBFMS trainee

2. ANATOMY

3. ANATOMY

4. ANATOMY

5. ANATOMY

6. ANATOMY

7. RANGE OF MOVEMENT

8. RANGE OF MOVEMENT

9. RANGE OF MOVEMENT

10. SHOULDER EXAMINATION

11. INTRODUCTION
SHOULDER EXAMINATION
• Wash your hands
• Introduce yourself to the patient.
• Clarify the patient’s identity.
• Explain what you would like to examine
• Gain their consent.
• Appropriately expose the joint

12. SHOULDER EXAMINATION
INSPECTION
• For:
– Alignment and posture
– Skin: scar , swelling, bruising, sinuses
– Bony prominence
– Muscles for wasting
– Arm position
Front
Side
Back

13. SHOULDER EXAMINATION
• For:
– Axilla: lymphadenopathy, effusion
– Winging of scapula

14. FEEL
SHOULDER EXAMINATION
• over the joint and its surrounding
areas for the TEMPERATURE
• Systematically feel along both sides
of the bony shoulder girdle for
TENDERNESS
• MUSCLES around the joint for any
tenderness.
• Check distal PULSES

15. MOVEMENTS
SHOULDER EXAMINATION
• Ask the patient to perform all
shoulder movements ACTIVELY
• Then you should perform them
PASSIVELY and feel for any
crepitus
Flexion
Extension

16. Abduction
Adduction
External rotation
Internal rotation

17. SPECIAL TESTS
SHOULDER EXAMINATION
Impingement test
Instability tests
Rotator cuff pathology
Biceps tendinitis
Labral pathology
AC joint tests
Thoracic outlet syndrome

18. SPECIAL TESTS/ Impingement test
SHOULDER EXAMINATION
Neer Impingement Sign
Neer Impingement Test
the test is repeated after injection of 10–15
mL of 1% xylocaine into the subacromial space
Neer Impingement Sign

19. SPECIAL TESTS/ Impingement test
SHOULDER EXAMINATION
Hawkins Test
Jobe’s Test (Empty Can Test)
Hawkins Test
Empty Can Test

20. SPECIAL TESTS/ Rotator Cuff Pathology
SHOULDER EXAMINATION
Supraspinatus Tests:
 Supraspinatus Strength
 Jobe (empty can)Test
 Drop Arm Sign
Infraspinatus tests:
 Infraspinatus Strength
 External Rotation Lag Sign

21. SPECIAL TESTS/ Rotator Cuff Pathology
SHOULDER EXAMINATION
Subscapularis Tests:
 Subscapularis Strength
 Internal Rotation Lag Sign
 Lift Off Test
 Belly Press Test
Internal Rotation Lag Sign
Lift Off Test Belly Press

22. SPECIAL TESTS/ Rotator Cuff Pathology
SHOULDER EXAMINATION
Teres Minor tests:
 Teres Minor Strength
 Hornblower's sign

23. SPECIAL TESTS/ Instability tests
SHOULDER EXAMINATION
Anterior Instability:
 Apprehension(Crank )and
Relocation Test
 Anterior Drawer(Load and Shift)
Test

24. SPECIAL TESTS/ Instability tests
SHOULDER EXAMINATION
Posterior Instability:
 Posterior Drawer
 Jerk test
Inferior Instability:
 Sulcus Sign

25. SPECIAL TESTS/ Biceps tests
SHOULDER EXAMINATION
Bicipital Groove Tenderness
Tests:
 Speed's Test
 Yergason's Sign
Popeye Sign
Speed's Test
Yergason's test

26. SPECIAL TESTS/ AC Joint
SHOULDER EXAMINATION
Acromioclavicular joint tenderness
Tests:
 Cross-Body Adduction test
(scarf test)
 AC Resisted Extension Test
Scarf Test
AC Resisted Extension Test

27. SPECIAL TESTS/ Labral lesion
SHOULDER EXAMINATION
SLAP Lesion
Tests:
 O’Brien’s test
1 2

28. SPECIAL TESTS/ Thoracic Outlet Syndrome
SHOULDER EXAMINATION
 Wright's Test
 Adson’s test
 Roo’s test
Wright's Test
Adson’s test
Roo’s test

29. • Quick Function Test
SHOULDER EXAMINATION
 Both Arms behind head
 Both Arms behind back
 Apley’s scratch test

30. To Complete Exam….
SHOULDER EXAMINATION
Tell the examiner that you would like to
examine:
 Joint above (Cervical Spine)
 Joint below (Elbow Joint)
 Neurovascular distal to the joint

31. The End
SHOULDER EXAMINATION
 allow the patient to dress

 Thank them for their time
 Wash your hands
 Report your findings to the examiner.