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Clinical and diagnostic tests for shoulder disorders: a critical review
  1. Edward G McFarland,
  2. Juan Garzon-Muvdi,
  3. Xiaofeng Jia,
  4. Pingal Desai,
  5. Steve A Petersen
  1. Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Dr Edward G McFarland, c/o Elaine P Henze, BJ, ELS, Medical Editor and Director, Editorial Services, Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, #A665, Baltimore, MD 21224–2780, USA; ehenze1{at}


The shoulder is one of the most complex joints in the human body and, as such, presents an evaluation and diagnostic challenge. The first steps in its evaluation are obtaining an accurate history and physical examination and evaluating conventional radiography. The use of other imaging modalities (eg, ultrasound, magnetic resonance imaging and computed tomography) should be based on the type of additional information needed. The goals of this study were to review the current limitations of evidence-based medicine with regard to shoulder examination and to assess the rationale for and against the use of diagnostic physical examination tests.

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  • Competing interests None.

  • Provenance and peer review Commissioned; not externally peer reviewed.