Pain in the shoulder region is a common reason for seeking medical attention. When shoulder pain presents as an isolated problem, the cause is usually periarticular disease that can be diagnosed accurately by clinical examination. It is not uncommon for shoulder pain to be referred from adjacent areas or internal organs. While isolated affection of the glenohumeral joint is rare, this joint is often involved in a variety of polyarthropathies.
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Try elevating your arms in abduction up to 180°, keeping the palms of your hands facing down. Did you manage? Congratulations! Many people cannot do it without rotating their palms upwards when they reach about 90° abduction because there is not enough subacromial space to accommodate the greater tuberosity. They are therefore forced to induce external rotation of the humerus, moving the greater tuberosity behind the acromion.
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Try it on yourself. Place your right hand at rest along your body. Press the head of the humerus with your left index finger just below the anterior vertex of the right acromion. Now rotate your hand inwards and outwards – the bony prominence that you can feel deep down gliding under your finger is the greater tuberosity.
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A young patient with selective shoulder pain – pain worse during active than passive mobilization, without range limitations. Rotator cuff maneuvers positive.
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See Chapter 30 for guidance on the technique.
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In fact, we also looked for osteoporosis. This is a typical situation in which we should consider this condition as there are a number of risk factors: post-menopausal woman with an early menopause, underweight and a family history suggesting the disease.
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See Chapter 30 for guidance on the technique.
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Inflammatory shoulder and back pain in a patient with psoriasis. Limited active and passive mobility in the painful areas.
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da Silva, J.A.P., Woolf, A.D. (2010). Regional Syndromes The Painful Shoulder. In: Rheumatology in Practice. Springer, London. https://doi.org/10.1007/978-1-84882-581-9_8
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DOI: https://doi.org/10.1007/978-1-84882-581-9_8
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