inspection
Last reviewed 07/2023
Inspection of the shoulder joint is the first step in examination. There should be careful comparison with the opposite side. Points of note include:
- initial inspection:
- discolouration e.g. erythema
- abrasions
- scars
- asymmetry
- position arm held in e.g. adduction with arm held across anterior chest
- clavicle:
- absence; shoulders appear rounded
- altered smooth contour of shaft - possible fracture
- overriding at either end - dislocation
- deltoid muscle:
- normally smooth, symmetrical contour to lateral aspect of shoulder
- prominence of greater tuberosity of humerus - wasting of deltoid
- dimpling of contour below acromion laterally - possible dislocation with arm held in abduction
- presence of deltopectoral groove delineating the interface of deltoid and pectoralis major
- scapula:
- triangular in shape
- vertebral border approximately 3-4 cm from spinous processes
- covering ribs 2-7 posteriorly
- spine of scapula roughly at level of T3
- inspection may reveal Sprengel's deformity or winging
- spine:
- scoliosis
- kyphosis
- movement with gait; the arm should swing in unison with the opposite lower limb