Assessment of the shoulder
The examination really starts before the history is taken. For instance, a handshake may demonstrate the shoulder shrug of a full thickness massive rotator cuff tear (Figure 2.7). Particular attention should be paid to the difficulties the patient has in removing a shirt or jacket. The surgeon must remember that the shoulder is really a series of joints - the sternoclavicular, acromioclavicular, sternothor-acic, subacromial and finally the glenohumeral. The neck should be examined, as should the elbow, wrist and hand. This chapter, however, will consider the shoulder girdle alone.