Shoulder examination osce pdf

Shoulder pain leads many patients to see a primary care physician. First, the shoulder is carefully inspected visually, followed by palpation and rangeofmotion assessment. Ms abu is a 40 yearold gp who reports weakness in her right arm. If indicated, functional assessment is performed next and may be followed by a neurological assessment, as necessary. The view from the side detects any recurvatum or lack of complete extension. Check out the shoulder examination mark scheme here. This shoulder examination osce guide provides a clear step by step approach to examining the shoulder, with an included video demonstration. You should ensure you are able to perform this confidently. A focused history is the most valuable yet least effectively used tool in clinical medicine. Position always position your patient as you would like to examine them before you begin. There are 6 main concepts that need to be remembered for all of the regional examination of the musculoskeletal system. It is a disorder that can is present in a whole multitude of diseases.

Laxity, instability, and superior labral anterior and posterior slap lesions t. Other causes are degenerative joint disease and arthritis. It is useful in identifying pathology that affects the upper limbs. Osce stations examination mbbs4 orthopaedics shoulder exam shoulder exam may 28, 2016 examination mbbs4 orthopaedics print pdf. Although traumatic anterior shoulder instability is common, the usefulness of various physical examination tests as tools for the diagnosis of this condition has been studied infrequently. The objective structured clinical exams osces cases cover common and important situations that a physician is likely to encounter in common medical practice in clinics, doctors offices, emergency departments, and hospital settings in real practice. So far, i have tried to collect as many of the tests i can find and list them here. Abduct shoulder to 90 o and slowly internally rotate while a gentle axial load is applied to the glenohumeral joint. Musculoskeletal exam osce stations in musculoskeletal exams it is all about 1 look, 2 feel, 3 move, 4 special tests. Youll be expected to pick up the relevant clinical signs using your examination skills.

If you remember these steps then it will help perform the. Shoulder examination osce guide old version youtube. The upper limb neurological examination is part of the neurological exam that focuses on the motor and sensory neurons that innervate the upper limbs. Our shoulder examination checklist contains all of the same physical examination points included on a recent shoulder examination osce used to evaluate orthopedic residents. As you palpate, look at the patients face to see if you elicit any pain. Download the shoulder examination pdf osce checklist, or use our interactive osce checklist. Bobby masocol md primary care sports medicine fellow. Shoulder examination osce guide old version duration. Objective structured clinical examination osce article pdf available in occasional paper royal college of general practitioners 4646.

The shoulder is a ball and socket joint formed from three bones the clavicle. Exploring the use of videotaped objective structured. The examination of all joints follows the general pattern of look, feel, move and occasionally some special tests. Then feel the greater tuberosity and in the anterior and posterior joint lines. Competency based clinical shoulder examination training. Meyers, md from orthopaedic research of virginia, richmond, virginia. Examination of the shoulder joint introduction introduce yourself wash hands briefly explain to the patient what the examination involves ask the patient to expose their shoulders fully inspection look anterior, lateral, and posterior asymmetry or deformity scars or skin changes muscle bulk palpate temperature. Ask the patient if they have any pain before you start palpating. The patient may present with the typical features of inflammation, a hot, red, swollen and painful joint, or just some of these, depending on the cause. Feel for example, feeling a joint to see if it is hot or swollen. Instability the common disorders arise from diseases of the following structures.

The ability to test these in a systematic and slick manner is one of the key. Shoulder exam stanford medicine 25 stanford medicine. In each case it is important to be familiar with some basic examination tools that can help us confirm the presence of a shoulder lesion. Swelling of the shoulder joint may be visible due to a joint effusion, or synovial thickening. Addison osce is a 68yearold patient who is scheduled for an arthroscopic leftsided rotator cuff repair. The etiology is most of the time traumatic and related either to sport or accidents. Numerous clinical tests described for shoulder examination.

The recommended progression of shoulder examination maneuvers is inspection, palpation, range of motion and strength tests, and provoca tive tests. Look inspect and observe the patient and around the patients bedside. To complete exam to complete my examination i would examine the joint above and joint below, and also do a full neurovascular exam distal to. All osce notes and osce examinations are downloadable for medicine osce exam finals revision.

Many similar tests have been described by different people and given different names. Briefly explain to the patient what the examination involves. Table 4 provides details of the muscles of the shoulder and figure 38ad illustrations of. Pain suggests ac pathology apprehension test o have the patient in the supine position. Shoulder examination introduction shoulder disorders are can be broadly classified into the following types. This video produced by students at oxford university medical school in conjunction with the faculty demonstrates how to perform an orthopaedic examination of the shoulder joint.

Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Osces examiner checklist objective structured clinical. Deformity of the joint and fractures and dislocations are usually obvious figure 37a,b. Meyers, md from orthopaedic research of virginia, richmond, virginia careful examination of the shoulder is an essential component in forming a diagnosis of problems in this area. Hand and wrist examination musculoskeletal osce skills. See the written guide alongside the video here examination download the app here. Resisted shoulder tests abdn, med rotn, lat rotn 4. Shoulder pain is one of the most common complaints in the outpatient setting. The hand and wrist examination, along with all other joint examinations, is commonly tested on in osces.

Compared to other joint exams, the shoulder examination is often chosen as an osce station and you should prepare for it accordingly. Perform a focused physical exam of the shoulders, explaining what you are doing, what you are looking for, and what you are finding as you go. The examination of all joints follows the general pattern of look, feel, move as well as. With dvd containing narrated footage of examination techniques. The shoulder examination follows the look, feel, move rule of joint exams. Arthritis means inflammation of a joint arthron in greek. A 51year old man comes into the office for right shoulder pain, progressive over the last 3 weeks, aggravated by his work sanding car hoods. An extension to this station may be to assess the rotator cuff muscles individually, you should therefore be aware how to do this. Please perform an upper limb neurological system examination and report your findings as you go along. You are a junior doctor on your general practice rotation. Pain, catching, or grinding in the shoulder indicates a labral tear slap lesion. Common causes include osteoarthritis, rheumatoid arthritis, gout and pseudogout, septic arthritis, the. Upper limb neurological examination osce guide new version duration. Vague shoulder pain with a normal physical examination should increase.

Feel this joint, then move along and feel along the spine of the scapula. Special tests impingement, cuff, labrum, instability 5. Shoulder examination introduction 1 introduce yourself to the patient including your name and role 2 con. Thus you are evaluated as if it is a real life practice. A shoulder examination should be performed in a systematic manner. The patient reports stiffness and pain in the shoulder for the last 6 months. Start at the sternum, and move laterally along the clavicle, until you reach the acromioclavicular joint. The complex structure of the shoulder, with its variable pathological conditions of rotator cuff disease, degenerative joint disease, and type ii slap lesions, makes clinical examination and assessment difficult for. The shoulder examination, along with all other joint examinations, is commonly tested on in osces. Shoulder examination musculoskeletal osce skills medistudents. The exam for shoulder pain stanford medicine 25 duration. Introduce yourself to the patient including your name.