A shoulder examination (or shoulder exam) is a portion of a physical examination used to identify potential pathology involving the shoulder. It should be conducted with both shoulders exposed to assess for asymmetry and muscle wasting.
Evaluation of passive and active range of motion: Neck range of motion should be assessed that may reveal a neck source of shoulder pain. The Apley scratch test specifically tests range of motion and in a normal exam, an individual should be able to reach C7 on external rotation, and T7 on internal rotation.
A meta-analysis in 2008 concluded that the diagnostic accuracy of individual tests in the shoulder examination was limited, specifically that the Hawkins–Kennedy test and the Speed test have no discriminatory ability to diagnose specific shoulder pathology, and that results of studies evaluating other tests were too statistically heterogeneous to make meaningful conclusions about their diagnostic accuracy.[3]
Examination of the shoulder can be complex because the shoulder can present with more than one pathology at a time.[4]
References
^THOMAS W. WOODWARD, M.D.; THOMAS M. BEST, M.D. (May 15, 2000). "The Painful Shoulder: Part I. Clinical Evaluation". Am Fam Physician. 61 (10): 3079–3088. PMID10839557.