Diagnosis of Shoulder Joint Pain: Symptoms, Physical Exam, Investigations, Tests

Shoulder joint performs wide range of movements. Pain is a predominant symptom of shoulder joint disease. Shoulder joint movement triggers pain at various positions of shoulder joint during activities. Intensity of the pain also varies with type of injuries.

• Very Severe Shoulder Pain at Rest-
  1. Joint Dislocation
  2. Joint Fracture
• Moderate Shoulder Pain at Rest-
  1. Tendonitis
  2. Bursitis
  3. Arthritis
  4. Shoulder joint sprain
  5. Frozen shoulder
• Mild Shoulder Pain at Rest
  1. Bursitis
  2. Shoulder Joint Sprain

• Very Severe Shoulder Pain with Activities
  1. Joint Dislocation
  2. Joint Fracture
  3. Advanced Rheumatoid Arthritis
  4. Advanced Osteoarthritis
  5. Septic Arthritis
• Moderate Shoulder Pain with Activities
  1. Tendonitis
  2. Bursitis
  3. Osteoarthritis
  4. Rheumatic Arthritis
  5. Shoulder Joint Sprain
• Mild Shoulder Pain With Activities
  1. Bursitis
  2. Shoulder Joint Sprain

Shoulder joint stiffness is caused by stiff ligament, muscle or tendon. Joint stiffness caused by severe pain results in difficulties in joint movement and restricted range of joint motion. Causes of Shoulder Joint Stiffness are as follows.

• Shoulder Joint Fracture
• Shoulder Joint Dislocation
• Advanced Shoulder Joint Arthritis
• Frozen Shoulder

Patient may complain of weakness in upper arm. Muscle weakness may be rapid or slow in occurrence.

• Selective motor nerve (nerve to muscle) injury with associated dislocation or fracture of shoulder joint.
• Brachial Plexus Injury associated with shoulder joint pain

• Rheumatoid Arthritis.
• Septic Arthritis.
• Osteoarthritis.
• Chronic Tendonitis.

Tingling and numbness suggests sensory nerve injury. Tingling and numbness is caused by irritation or pinch of the sensory nociceptive (in carrying) nerve. Sensory nerve irritation or injuries are seen in following diseases.

• Shoulder Joint Dislocation.
• Shoulder Joint Fracture.
• Brachial Plexus Injury.

Shoulder joint swelling is either soft, firm or hard.

• Synovial fluid collection in shoulder joint.
• Rheumatoid arthritis causing increased synovial fluid secretion.
• Septic shoulder joint results in collection of pus (purulent discharged) in shoulder joint.

• Results from hematoma (blood clot).
• Joint subluxation.
• Partial dislocation as seen in rheumatoid arthritis.

• Shoulder Joint Dislocation.
• Shoulder Joint Fracture.

Cause Of Fever Is As Follows-

• Shoulder Joint Septic Arthritis.
• Bursitis Secondary To Infection Associated With Inflammation.
• Severe Rheumatoid Arthritis.

Bruises are purple skin discoloration. Following complication of shoulder joint illnesses causes bruises:

• Subcutaneous Hematoma.
• Shoulder Joint Hematoma secondary to profuse bleeding.

Shoulder joint pain restricts shoulder joint movements, which results in muscles wasting. Wasting is most often seen following dislocation, fracture and shoulder joint surgery. Muscles show signs of wasting and thinning when not frequently used. Muscle wasting is observed with following diseases.

• Shoulder Joint Fracture
• Shoulder Joint Dislocation
• Following Surgery
• Chronic Severe Pain Caused By Arthritis Of Shoulder Joint.
• Frozen Shoulder Joint
• Tear of Tendon
• Tear of Ligaments

Shoulder joint swelling suggests enlarged joint. Joint swelling is soft to firm in consistency.

• Rheumatoid Arthritis
• Septic Arthritis

• Septic Arthritis- Pus In The Joint
• Rheumatoid Arthritis- Synovial fluid in shoulder joint.
• Shoulder Joint Hematoma

• Shoulder Joint Fracture- Fracture segment protrudes through soft tissue.
• Shoulder Joint Dislocation- Dislocated section of joint protrudes out through soft tissue.

Causes Of Evenly Spread Shoulder Joint Deformity Is As Follows-

• Septic Shoulder Joint
• Shoulder Joint Hematoma
• Shoulder Joint Swelling Caused By Rheumatoid Arthritis.

Causes of Uneven Deformity Of Shoulder Joint-

• Shoulder Joint Dislocation.
• Shoulder Joint Fracture.

Restricted range of movement is described as mild, moderate or severe restriction.

Causes of Restrictions of Shoulder Joint Movement Are As Follows:

• Arthritis
• Bursitis
• Joint Sprain
• Tendonitis

• Hematoma
• Septic Arthritis

• Dislocation
• Fracture

Following Diseases Causes Warm Shoulder Joint

• Osteoarthritis
• Rheumatoid Arthritis
• Psoriatic Arthritis
• Infection
  1. Septic Arthritis
  2. Infected Bursitis

Shoulder joint is a ball and socket joint. Following Diseases Causes Shoulder Joint Instability

• Degenerated Uneven Cartilage
• Degenerated or Torn Ligament
• Loose Capsule

• Loose or Stiff Inflamed Synovial Membrane
• Excessive Synovial Fluid In The Joint
• Tendon Degeneration

• Joint Expansion By Blood Clot
• Subluxation of Joint
• Overstretched Ligaments

• Collection of Pus or Abscess
• Overstretched Ligament
• Loose Joint Capsule

• Partial Shoulder Joint Dislocation
• Loose Ligament

• Loose Ligaments
• Shoulder Joint Dislocation
• Loose Joint Capsule

Following diseases are diagnosed by using X-Ray

• Shoulder Joint Dislocation
• Shoulder Joint Fracture

MRI scanning shows details of soft tissue and bones compared to X-ray of shoulder joint. MRI machine uses high-powered magnet to create high-resolution images. Sophisticated computer analyzes images before displaying on screen. The images are printed for future reference.

Following Shoulder Joint Diseases Are Diagnosed Using MRI-

• Shoulder Joint Dislocation
• Shoulder Joint Fracture
• Tendonitis
• Bursitis
• Joint Hematoma
• Subcutaneous Hematoma
• Septic Arthritis

CAT scan takes multiple X-Ray pictures while scanning the soft tissue and bones. The images are analyzed and processed by advanced computers.

Following disease are diagnosed by CAT scan:

• Shoulder Joint Dislocation
• Shoulder Joint Fracture
• Tendonitis
• Bursitis
• Joint Hematoma
• Subcutaneous Hematoma
• Septic Arthritis

Probe of ultrasound is placed over shoulder joint and ultrasound waves are passed through skin and solid bony structure. The information is collected to analyze soft tissue and bone abnormalities. The study is beneficial to diagnose fluid collection in the joint and abnormal alignment of the joint.

Following Shoulder Joint Problems Are Diagnosed With Ultrasound-

• Shoulder Joint Fracture
• Joint Hematoma
• Subcutaneous Hematoma
• Septic Arthritis- Abscess in the joint

Following Shoulder Joint Diseases Are Diagnosed With EMG Study-

• Evaluate Sensory And Motor Nerve Function
• Brachial Plexus Injury

Arthrogram is a dye study. Dye is injected in the shoulder joint and spread of dye is studied by X-ray or CAT scan. Arthrogram provides anatomical structural information of the cartilage, ligaments, tendons and muscles within as well as surrounding the joint.

Arthrogram Evaluates The Continuity Of The Shoulder Joint. Arthrogram Shows Following Shoulder Joint Abnormalities-

• Joint Dislocation
• Joint Fracture
• Muscle Tear
• Cartilage Tear
• Tendon Tear

Arthroscopy is a procedure performed under general or local anesthesia. Arthroscope is an instrument also known as endoscope. Arthroscope is a thin tubular structure with camera at one end and eyepiece at other end. Camera end of the arthroscope is inserted into shoulder joint following tiny skin incision. The camera image is digitized, magnified and transferred to television screen. Orthopedic surgeon can see the interior structure of the joint either through eyepiece or over the television screen.

Following Shoulder Joint Diseases Are Diagnosed By Arthroscopy:

• Shoulder Joint Fracture
• Joint Hematoma
• Subcutaneous Hematoma
• Septic Arthritis- Abscess in the Joint
• Muscle Tear
• Joint Tear

Also Read: 8 Major Medical Conditions Causing Shoulder Joint Pain.

Also Read: Complete Treatment Options for Shoulder Joint Pain