Diagnostic classification of shoulder disorders
| Diagnostic categories | Main criteria | |
|---|---|---|
| 1 Capsular syndrome (adhaesive capsulitis, arthrosis, frozen shoulder, etc) | Capsular pattern: proportionally larger passive restriction of external rotation to glenohumeral abduction and internal rotation. Pain in C5 dermatome | |
| 2 Acute bursitis | Restriction of active and passive abduction, severe pain in C5 dermatome. Acute onset, no evident trauma | |
| 3 Acromioclavicular syndrome | Restriction of horizontal adduction. Pain in area of acromioclavicular joint and/or C4 dermatome | |
| 4 Subacromial syndrome (chronic bursitis, tendinitis, rotator cuff tears) | Painful arc during abduction. Pain in C5 dermatome. | |
| No restriction in passive range of motion. At least one positive resistance test. | ||
| Bursitis: variable/slight pain, no or slight muscle weakness | ||
| Tendinitis: pain, no or slight muscle weakness. | ||
| Cuff tears: little pain, moderate to severe muscle weakness | ||
| 5 Rest group | ||
| Unclear clinical picture | Signs and symptoms do not meet the criteria of one of the other diagnostic categories | |
| Extrinsic causes | Extrinsic causes such as cervical spine disorders, thoracic outlet syndrome, shoulder-hand syndrome, referred pain | |
| Other intrinsic causes | Glenohumeral instability | |
| No shoulder problems | No signs and symptoms indicating intrinsic or extrinsic shoulder disorders1-150 | |
| 6 Mixed clinical picture | Signs and symptoms do meet the criteria for two diagnostic categories† | |
↵1-150 Between the inclusion by the general practitioners, physicians or rheumatologists and the physical examination by the examiners recovery of the shoulder problems might have occurred. †If the signs and symptoms completely meet the criteria of one diagnostic category and to a lesser extent a second category, the first diagnostic category was chosen.