ShoulderDiagnostic Algorithm

Diagnostic Flowchart: Shoulder

Follow the algorithm step by step. Click on options to navigate through the decision tree.

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Shoulder Pain Assessment

Full Algorithm Overview

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Shoulder Pain Assessment

→ q_trauma
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History of acute trauma or dislocation?

Yes → q_deformityNo → q_stiffness
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Visible deformity or inability to move?

Yes → d_fracture_dislocationNo → q_acute_weakness
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Likely Fracture or Dislocation

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Significant weakness in abduction or external rotation?

Yes → d_acute_rc_tearNo → q_instability
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Suspected Acute Rotator Cuff Tear

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Feeling of shoulder "slipping out" or positive apprehension?

Yes → d_instabilityNo → q_ac_pain
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Shoulder Instability / Labral Tear

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Pain localized to top of shoulder (AC joint)?

Yes → d_ac_jointNo → q_impingement
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AC Joint Pathology

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Global restriction of passive ROM (especially external rotation)?

Yes → d_frozen_shoulderNo → q_impingement
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Adhesive Capsulitis (Frozen Shoulder)

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Painful arc 60-120°, positive Neer/Hawkins tests?

Yes → q_weakness_rcNo → q_neck_referred
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Significant weakness or positive drop arm test?

Yes → d_rc_tearNo → d_impingement
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Rotator Cuff Tendinopathy / Impingement

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Suspected Rotator Cuff Tear

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Pain radiates from neck? Dermatomal pattern? Neck movement reproduces pain?

Yes → d_cervicalNo → d_other
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Cervical Radiculopathy (Referred Pain)

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Consider: Calcific tendinitis, Biceps tendinopathy, or other causes