Shoulder Observations

What could bruising at the shoulder indicate?

• Muscle Rupture (Distal Biceps, Rotator Cuff)

• Fracture to bone (Clavicle most broken bone in the body)

What could redness at the shoulder indicate?

• General skin conditions (Eczema)

• Redness of the clavicle - Clavicular compression TOS

• With associated swelling - Bursitis (Eg. Subacromial)

• With associated swelling at SC or AC joint - RA or OA

What could swelling at the shoulder indicate?

• With associated redness - Bursitis

• With redness at SC or AC - RA or OA

• In bursal regions may be HADD

What could muscle wasting at the shoulder indicate?

• Disuse atroohy eg. GH joint dislocation causes lack of training of biceps or internal impingement

• May be seen in rotator cuff musculature in stage 1 of SAPS

What could scarring at the shoulder indicate?

• Previous surgery (Eg. Repairing a full thickness pec minor tear)

What could bumps at the shoulder indicate?

• Tumour such as a Pancoast tumour

• Cyst

• Poor healing broken bone

What could scapular winging indicate?

• Ipsilateral serratus anterior weakness

• Secondary to long thoracic nerve palsy

What could asymmetry of the shoulder girdles indicate?

• 1 side sitting lower due to scoliosis

• 1 side sitting lower due to long thoracic nerve paralysis

• Sprengel’s deformity seen posteriorly with 1 scapula sitting higher due to congenital growth failure

What should you look for at the shoulder?

• Bumps

• Bruising

• Redness

• Scarring

• Swelling

• Scapular winging

• Asymmetry

• Muscle wasting