A physical examination by a physician consists of observation to look for deformities, muscle wasting, and changes in appearance of the damaged shoulder compared to the normal one.
Palpation, or feeling the bones that make up the shoulder joint as well as the shoulder joint itself. Further evaluation might include assessment of range of motion of both shoulders, strength testing, pressing on different parts of the shoulder while moving the arm into different positions. Sensation and blood flow in the arm and hand may be assessed, feeling for pulses and determining if there is normal light touch, pain, and vibration sensation in the extremity.
A variety of tests may be performed to discover which of the four muscles of the rotator cuff is injured or damaged. Each uses muscle contractions to try to find the weak or painful muscle. The Jobe test for the supraspinatus tendon or the Patte test for the infraspinatus and teres minor muscles, or the Gerber test for subscapularis muscle.
One or more of the following diagnostic tests may be ordered as well:
X-Rays – A rotator cuff tear won’t show up on an x-ray, but the doctor will be able to see bone spurs or other potential causes for pain.
Ultrasound – Assesses the structures of the shoulder as it moves and allows for a quick comparison of the affected shoulder with the healthy one.
MRI – This provides all structures in the shoulder in great detail.
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