Examination Process

Patients with recurrent shoulder dislocations (habitual dislocations) can usually be identified through medical interviews. For others, we conduct interviews and evaluate physical findings—such as the degree of pain when moving the shoulder and other symptoms.
Most patients who visit the shoulder clinic complain of shoulder pain, difficulty raising the arm due to pain, or limited shoulder mobility.

Accurately assessing the nature of the pain during the initial consultation is critically important.
 

When exactly does the pain occur?

 
It is extremely important to determine:

• Whether the pain occurs at rest, that is, even when the patient is not moving
• Whether even slight movements cause pain
• Whether the pain is severe
• Whether the pain occurs during activity or movement

 
Pain at rest, pain with even slight movement, or severe pain is considered indicative of inflammation in the shoulder joint.
 
If physical examination findings indicate that the shoulder pain is primarily due to inflammation, we continue treatment aimed at reducing the inflammation.
If there is a limitation in the shoulder’s range of motion and significant joint contracture, and inflammation is not severe, physical therapy is prescribed to improve mobility.
However, if this is not the case, we consider the possibility that the pain is due to functional impairment caused by anatomical disruption (damage to the structural components of the shoulder joint), and proceed with further imaging studies such as MRI.
 
At that point, a specific condition can be suspected. Based on this process, we proceed to identify the possible disorder from the list below.
 
・肩関節周囲炎、拘縮Adhesive capsulitis (frozen shoulder), shoulder contracture
・腱板断裂Rotator cuff tear
・反復性肩関節前方不安定症Recurrent anterior shoulder instability
・石灰沈着性腱板炎Calcific tendinitis of the rotator cuff
・投球障害肩Thrower's shoulder (overhead athlete's shoulder injury)
・非外傷性肩関節不安定症Non-traumatic shoulder instability
・その他Others