ABSTRACT
Pain from the shoulder or its surrounding tendons is felt anterolaterally and at the insertion of the deltoid; sometimes it radiates down the arm. Pain on top of the shoulder suggests acromioclavicular dysfunction or a cervical spine disorder. Asymmetry of the shoulders, winging of the scapula, wasting of the deltoid or short rotators and acromioclavicular dislocation are best seen from behind; joint swelling or wasting of the pectoral muscles is more obvious from in front. Pectoralis major is tested by having the patient thrust both hands firmly into the waist. Magnetic resonance imaging is useful to identify osteonecrosis of the humeral head, or a bone tumour. The pain will be over the front and lateral aspect of the shoulder with weakness on abduction for supraspinatus involvement, tears of the cuff and tendinitis and over the front for biceps pathology.
