ABSTRACT
SYMPTOMS Pain is the commonest symptom. However, ‘pain in the shoulder’ is not necessarily ‘shoulder pain’! If the patient points to the top of the shoulder, think of the acromioclavicular joint, or referred pain from the neck. Pain from the shoulder joint and the rotator cuff is felt, typically, over the front and outer aspect of the joint, often as far down as the middle of the arm. The relationship to posture may be significant: pain which appears when the arm is in the ‘windowcleaning’ position is characteristic of rotator cuff impingement; pain which comes on suddenly when the arm is held high overhead suggests instability.
