Physical Exam
In the physical exam, doctors get data about the musculoskeletal ailment that patients may not be able to give on their own. For example, patients may not realize they have instability of the articulation or deformity in the case of rheumatoid arthritis.
The interpretation of the physical exam depends on the previous stages of the diagnosis. For example, when patients have a positive empty can test, their age is fundamental to knowing what problem they are more likely to have. It will probably be a rotator cuff tear in a patient after 50 years old, and younger patients probably have another problem in the same structure.
The physical exam of these patients includes the following steps:
- Observation: It is a fundamental step of the physical exam, and skillful doctors can apply observation from first sight when the patient is sitting in front of the desk. In a later stage, they may ask patients to remove the shirt to identify deformities or abnormalities in the shoulders.
- Palpation: In most cases, doctors would perform observation and palpation simultaneously because they complement each other. It is particularly useful to identify acromioclavicular joint pathologies.
- Range of motion evaluation: Evaluating the range of motion is also important to see how the pathology affects the shoulder’s function. Active and passive range of motion should be both evaluated. For example, when both passive and active range of motion is altered, doctors will suspect adhesive capsulitis and arthropathies.
- Special testing: There are plenty of special tests in the physical exam to help doctors determine the exact cause of the pain. For example, pain upon abduction between 60 and 120 degrees suggests subacromial impingement. So, doctors may ask you to perform certain movements or move your body to complete a specific maneuver to find out the cause of the pain. In this step, important parts of the physical exam include impingement testing and instability evaluation. For each one, there’s a different test or a group of physical exams to confirm the findings. In the following section, we will describe a few.