Shoulder examination (or shoulder exam) is a portion of a physical examination used to identify potential pathology involving the shoulder. It should be conducted with both shoulders exposed to assess for asymmetry and muscle wasting.
Elements of the shoulder examEdit
Inspection
Palpation of sternoclavicular joint, clavicle, acromioclavicular joint, subacromial bursa, bicipital tendon.
Evaluation of passive and active range of motion: Neck range of motion should be assessed that may reveal a neck source of shoulder pain. The Apley scratch test specifically tests range of motion and in a normal exam, an individual should be able to reach C7 on external rotation, and T7 on internal rotation.
Evaluation of distal pulses
Strength testing: wrist extension tests the radial nerve, finger abduction tests the ulnar nerve, and thumb apposition tests the median nerve.
Sensation testing
Reflex testing: Triceps reflex tests C6-C8, biceps reflex tests C5 and C6, and brachioradialis reflex tests C5-C7.
Provocative maneuvers.