EXTENDED REPORT

Painful shoulder: comparison of physical examination and ultrasonographic findings

E Naredo, P Aguado, E De Miguel, J Uson, L Mayordomo, J Gijon-Baños, E Martin-Mola

Department of Rheumatology, La Paz Hospital, Autonoma University of Madrid, Spain

Correspondence to:
Correspondence to:
Dr E Naredo, Calle Arturo Soria 259, portal 4, 4° A, 28033 Madrid, Spain;
enaredo{at}eresmas.com

Background: High frequency ultrasonography is an accurate non-invasive imaging technique for evaluating patients with painful shoulder.

Objective: To compare the clinical diagnosis established by a physical examination with high frequency ultrasonographic findings in patients with painful shoulder.

Methods: Thirty one consecutive patients with a first flare of shoulder pain were prospectively included in the study. All had a physical examination performed by two blinded rheumatologists. Ultrasonographic examination was carried out within one week of the physical examination by a third rheumatologist experienced in this technique who had no knowledge of the clinical findings. Ultrasonography was considered the optimal diagnostic technique.

Results: Clinical assessment showed low accuracy in the diagnosis of periarticular shoulder lesions.

Conclusion: Ultrasonography should be used wherever possible to improve diagnosis and treatment of painful shoulder.

Keywords: ultrasonography; physical examination; shoulder pain; diagnosis

Abbreviations: US, ultrasonography; PE, physical examination

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