Ask the expert: assessment of shoulder pain in primary care

What you need to knowSimple screening examinations can identify the anatomical location of pain in the shoulder, helping to narrow the diagnosisSuspicion of infection, tumour, neurological pathology, unreduced dislocation, or acute rotator cuff tear requires urgent referralSubacromial pain is the most common condition seen in primary care and can be treated with non-steroidal anti-inflammatory drugs, up to two subacromial corticosteroid injections, and physiotherapy prior to referral to secondary careOrthopaedic specialists Richard Murphy and Fiona Bintcliffe provide expert answers to GPs’ questions on shoulder pain, including advice on assessing patients with shoulder pain, clinical tests, when investigations may be indicated, and how to manage subacromial pain syndrome.Test yourselfYou make a diagnosis of subacromial pain syndrome in a 58 year old man who presents with non-traumatic pain in his right shoulder. The pain is localised around the acromion and is made worse by lifting his arm. He has a painful arc from…
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