Assessment of shoulder pain for non-specialists

#### What you need to know With more than 120 different “special tests” of the shoulder described,1 it is easy to see how its assessment can seem an enigma for non-specialists. Shoulder pain is common, and most cases will be managed in the community.2 Its prevalence in Dutch primary care is around 11 per 1000 patients seen each year,3 and as many as two in three people may experience it at some point in their life.4 Most diagnoses can be made from the patient’s history and examination considering relevant risk factors such as age, occupation, previous trauma, and relevant comorbidities. Here, we simplify the process of shoulder assessment to empower non-specialists evaluating a patient presenting with shoulder pain for the first time and provide an update on common shoulder pathologies. Take a targeted history —For some guide questions, see box 1. Watch out for features that may warrant secondary care specialist referral, orthopaedic or otherwise (fig 1⇓).5 #### Box 1: Questions for a targeted shoulder pain history Fig 1 Red flags for shoulder pain that warrant urgent referral. Images adapted from BMJ Best Practice (http://bestpractice.bmj.com/best-practice/monograph/709.html), Physiopedia (www.physio-pedia.com/Shoulder_Dislocation), LITFL (http://lifeinthefastlane.com/a-funny-fracture/ …