Shoulder History

Aka: Shoulder History

II. History: Injury

  1. Mechanism of Injury
    1. Direct blow to Shoulder (e.g. Fall on Shoulder)
    2. Fall on Outstretched Hand
  2. Prior Shoulder injuries or dislocations
    1. Shoulder Pain without Trauma is often due to Shoulder Impingement or calcific Tendinopathy

III. History: Age at onset

  1. Under age 40 years old
    1. Glenohumeral Instability (especially if history of Trauma)
      1. Shoulder Dislocation
      2. Shoulder Subluxation
    2. Shoulder Impingement
  2. Over age 40 years old
    1. Rotator Cuff Tear (especially if history of Trauma)
    2. Shoulder Adhesive Capsulitis
    3. Glenohumeral Osteoarthritis

IV. History: Timing

  1. Night pain
    1. Rotator Cuff Tear or Shoulder Impingement
    2. Adhesive Capsulitis

V. History: Provocative factors

  1. Pain with overhead activity
    1. Rotator Cuff Tear
    2. Shoulder Impingement
  2. Collision Sports or overhead activities (Throwing sports and Raquet sports)
    1. Glenohumeral Instability (Shoulder Dislocation, Shoulder Subluxation)
    2. Rotator Cuff Tear or Shoulder Impingement

VI. History: Associated Symptoms

  1. Arm weakness
    1. Rotator Cuff Tear (esp. complete tear)
    2. Shoulder Impingement
    3. Glenohumeral Osteoarthritis
    4. Peripheral Neuropathy (e.g. Cervical Radiculopathy)
  2. Decreased Shoulder Range of Motion
    1. Adhesive Capsulitis
    2. Severe Glenohumeral Osteoarthritis
  3. Distal arm Paresthesias beyond elbow (esp. if Neck Pain)
    1. Cervical disc disorder
    2. Thoracic Outlet Syndrome
  4. Instability sensation (especially if history of prior Shoulder Dislocation)
    1. Glenohumeral Instability (Shoulder Dislocation, Shoulder Subluxation)
  5. Catching or locking sensation
    1. Glenohumeral labrum tear
    2. Glenohumeral Arthritis
  6. Comorbid conditions or referred pain
    1. See Shoulder Pain for differential diagnosis
    2. Diabetes Mellitus predisposes to Adhesive Capsulitis

VII. References

  1. Kiel and Koneru (2019) Crit Dec Emerg Med 33(9): 17-27
  2. Yedlinsky (2021) Am Fam Physician 103(3):147-54 [PubMed]

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