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SHOULDER JOINT (OBSERVATION) PART III

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  The patient must be suitably undressed so that the examiner can observe the bony and soft tissue contours of both shoulders and determine whether they are normal or symmetric. when observing the shoulder , the examiner look at the head , the cervical spine , the thorax ( especially the posterior aspect) and the entire upper limb . It is important to observe the patient as he or she removes clothes from the upper body and later replaces them. The patients actions give some indication of functional restriction ,pain or weakness in the upper limb. As part of the observation , noting whether the patient can assume a "neutral pelvis" position is important, because an abnormal pelvic position can lead to an abnormal scapulothoracic , glenohumeral and cervical spine position and abnormal kinematics in these joints. ANTERIOR VIEW  The examiner should begin by ensuring that the head and neck are in the midline of the body and observing their relation to the shoulders. A FORWAR...

SHOULDER JOINT ( PATIENT HISTORY) PART II

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 The following questions should be part of the  SHOULDER JOINT  PATIENT HISTORY Most commonly , the patient complains of pain , especially on movement, restricted motion or shoulder instability. AGE- RELATED Many problems of the shoulder can be age related. Rotator cuff degeneration usually in patients who are between 40 and 60 years of age .  Rotator cuff tear occurs at any age .It осcur when external rotators and abductor muscles of shoulder are weak Primary impingement due to degeneration occurs at any age above 35 years. Secondary impingement occurs at teenage or twenties or due to overhead vigorous activities like swimmers or pitcher in baseball. Chondrosarcomas occur at any age above 30 years Frozen shoulder are seen in person between age of 45 and 60 years if it result from causes other than trauma . Frozen shoulder due to trauma occur at any age. PAIN IN MOVEMENT  Patient support the upper limb in protected position due to pain . If there is an acut...