Shoulder Examination Checklist

Question 1

What is the sulcus sign test for suspected shoulder instability?

Answer 1

With the patient standing, arm straight and relaxed by their side, place one arm on the shoulder girdle to stabilize it. Use the other hand to hold the wrist and exert a force in an inferior direction.

Positive test = a sulcus sign is seen if a depression appears just below the acromion.

Question 2

How do you perform the anterior and posterior drawer tests?

Answer 2

With the patient lying supine, stabilize the shoulder girdle with one hand and grasp the humeral head with the other hand to displace the shoulder anteriorly and then posteriorly.

Positive test = displacement of the humeral head anteriorly or posteriorly confirms instability.

Question 3

What is the anterior apprehension and relocation test?

Answer 3

With the patient lying supine, externally rotate the shoulder with the elbow flexed.

Positive test = the patient appears apprehensive as the humeral head subluxes anteriorly. The humeral head can be relocated with pressure applied anteriorly, resolving the apprehension.

Question 4

How is the posterior apprehension test performed?

Answer 4

Exert pressure through the elbow with the shoulder flexed at 90 degrees.

Positive test = the patient appears apprehensive during the test.

Question 5

How do you test for scapula winging?

Answer 5

Place the palms against a wall in full elbow extension at shoulder height and ask the patient to draw the chest towards the wall. Then repeat at waist height.

Positive test = scapula winging is observed, suggesting weakness in either serratus anterior or trapezius muscle.

Question 6

Look

Question 7

Feel

Question 8

Move