Pain or Limitation of Shoulder Movements

CLINICAL DIAGNOSTIC MANUAL

Pain or limitation of shoulder movements are common problems that can result from a variety of conditions, ranging from acute injuries to chronic diseases.

These issues can significantly affect arm functionality and the patient’s quality of life. Accurate identification of the underlying cause is essential to provide appropriate treatment and prevent complications.

Condition	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Subacromial Impingement	Pain in the upper shoulder, worsens with arm elevation, nocturnal pain	History of pain with overhead movements	Positive Hawkins-Kennedy test, MRI or ultrasound showing impingement
Rotator Cuff Tear	Pain, weakness, limited movement, especially when lifting the arm	History of shoulder pain and weakness	MRI showing rotator cuff tear, ultrasound
Supraspinatus Tendinitis	Pain in the upper shoulder, especially with lateral arm elevation	History of pain with lateral arm movements	MRI or ultrasound showing supraspinatus tendon inflammation
Bicipital Tendinitis	Pain in the anterior shoulder, pain when flexing the elbow against resistance	History of anterior shoulder pain and tenderness over the bicipital groove	MRI or ultrasound showing bicipital tendon inflammation
Long Head of Biceps Tendon Rupture	Acute pain, “snapping” sensation, deformity (“Popeye sign”)	History of acute shoulder pain and arm deformity	MRI or ultrasound showing tendon rupture
Frozen Shoulder (Adhesive Capsulitis)	Diffuse pain and progressive stiffness, significant limitation of movement	History of progressive pain and stiffness without evident trauma	Clinical evaluation, MRI showing joint capsule thickening
Acromioclavicular Joint Osteoarthritis	Pain in the upper shoulder, especially when crossing the arm in front of the body	History of acromioclavicular joint pain	X-ray showing osteoarthritis, MRI or ultrasound
Rheumatoid Arthritis	Pain, swelling, morning stiffness, involvement of multiple joints	History of joint pain and stiffness, rheumatoid nodules	Positive RF and anti-CCP, X-rays showing joint erosions
Soft Tissue Injury	Pain, swelling, bruising, limited movement depending on injury severity	History of overexertion or trauma	Ultrasound or MRI to evaluate tendons, ligaments, and bursae
Fracture	Acute pain, visible deformity, swelling, inability to move the shoulder	History of trauma, intense pain and deformity	X-ray showing fracture
Septic Arthritis	Severe pain, swelling, fever, erythema and warmth over the joint	History of recent infection or immunosuppression	Synovial fluid analysis, positive culture
Glenohumeral Osteoarthritis	Chronic pain, stiffness, crepitus with shoulder movement	History of progressive shoulder pain and stiffness	X-rays showing degenerative changes, MRI