Shoulder Disorders

Mar 1, 2019 Issue
Adhesive Capsulitis: Diagnosis and Management [Article]

Adhesive capsulitis is a painful shoulder condition that limits range of motion. Treatments include physiotherapy, intra-articular corticosteroid injections, and manipulation under anesthesia, although the most effective treatment is uncertain. Recent clinical evidence of persistent functional limitation of the shoulder lasting for years after no treatment has shown that early treatment is the best option for improvement in pain and range of motion.

Jul 1, 2018 Issue
Surgery Equal to No Surgery for Patients with Subacromial Shoulder Pain [POEMs]

In patients with subacromial shoulder pain of at least three months' duration who receive physical therapy, surgical decompression is no better than arthroscopy without decompression in improving pain or function, and neither is much better than no invasive intervention at all.

Nov 1, 2017 Issue
History and Physical Examination for Identifying Rotator Cuff Tears [FPIN's Help Desk Answers]

There are no historical features that reliably identify full-thickness rotator cuff tears. The physical examination maneuvers that best identify the presence of a full-thickness rotator cuff tear are the internal rotation lag test, the external rotation lag test, and a positive “belly-off” sign. The...

Dec 1, 2016 Issue
Rotator Cuff Disease: Diagnostic Tests [FPIN's Help Desk Answers]

A positive lag sign with external rotation is the best test for full-thickness tears of the infraspinatus and supraspinatus (positive likelihood ratio = 7.2). A positive lag sign with internal rotation is best for assessing full-thickness tears of the subscapularis (positive likelihood ratio = 5.6).

Jul 15, 2016 Issue
Acute Shoulder Injuries in Adults [Article]

Many common acute shoulder injuries can be managed without surgery by a knowledgeable family physician; however, it is important to know when to refer to an orthopedist. Learn about diagnostic clues, conservative management options, and indications for referral.

Oct 1, 2013 Issue
Ultrasound-Guided Steroid Injections for Shoulder Pain [Cochrane for Clinicians]

Ultrasound-guided glucocorticoid injection for shoulder pain provides no advantage over landmark-guided or intramuscular injection in terms of pain, function, range of motion, or safety when measured within a six-week follow-up period. However, the small sample size of this review means that a clinically significant benefit cannot be ruled out.

Feb 15, 2011 Issue
Adhesive Capsulitis: A Review [Article]

Adhesive capsulitis is a common, yet poorly understood, condition causing pain and loss of range of motion in the shoulder. It can occur in isolation or concomitantly with other shoulder conditions (e.g., rotator cuff tendinopathy, bursitis) or diabetes mellitus. It is often self-limited, but can pe...

Jan 15, 2011 Issue
Shoulder Pain [Clinical Evidence Handbook]

What are the effects of oral and topical drug treatment in persons with shoulder pain?What are the effects of local injections, nondrug and surgical treatments in persons with shoulder pain?

Sep 1, 2008 Issue
Shoulder Osteoarthritis: Diagnosis and Management [Article]

Osteoarthritis of the shoulder is a gradual wearing of the articular cartilage that leads to pain and stiffness. As the joint surface degenerates, the subchondral bone remodels, losing its sphericity and congruity. The joint capsule also becomes thickened, leading to further loss of shoulder rotatio...

Feb 15, 2008 Issue
Chronic Shouler Pain Part I: Evaluation and Diagnosis [Article]

Shoulder pain is defined as chronic when it has been present for longer than six months. Common conditions that can result in chronic shoulder pain include rotator cuff disorders, adhesive capsulitis, shoulder instability, and shoulder arthritis. Rotator cuff disorders include tendinopathy, partial ...

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