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How are specific shoulder conditions diagnosed?

If your shoulder problem continues for more than two weeks, or gets worse, you should see a doctor.

Each shoulder problem has its own pattern of symptoms. Most conditions will cause pain when you use or move your shoulder, and some will cause your shoulder to become stiffer. Your doctor or physiotherapist will need to establish which movements produce the most pain, because this could indicate where the problem is. Your doctor will usually ask how the problem started, how it has developed and how it affects your daily activities.

Usually your symptoms and the doctor’s examination of your shoulder will give all the information needed to plan your treatment. However, your doctor may suggest tests if they suspect arthritis or to rule out other conditions.

What tests are there?

  • Blood tests aren’t usually required for most shoulder problems, but they're sometimes used to rule out other conditions, including some types of arthritis.
  • X-rays are good for looking at the bones of the shoulder but they won't show problems in the soft tissues around the joint - the muscles, tendons or cartilage. An x-ray may also show a deposit of calcium in the tendons which can sometimes cause inflammation and pain (acute calcific tendinitis). An x-ray can show changes caused by arthritis in the shoulder joint.
  • An ultrasound scan can be helpful. It allows the soft tissues of the shoulder to be seen, and can detect fluid and damage to tendons and muscles. It may show tears in the rotator cuff. Ultrasound or MRI can help confirm the cause of a painful arc or impingement syndrome.
  • Magnetic resonance imaging (MRI) scans may be carried out may be carried out if your doctor suspects a more complex shoulder problem, or if you're likely to need specialised treatment. An MRI scan allows the soft tissues to be seen and is particularly helpful in identifying tears in the rotator cuff tendons. Occasionally a contrast dye is injected into the shoulder before the scan is carried out – this allows more detail to be seen, especially in cases of shoulder dislocation.
  • Nerve conduction studies can help determine whether the nerves in your arm are being squeezed or irritated. Very small electrodes are placed in or over the muscles and a reading is taken of the electrical activity in the muscles and nerves. You may feel slight pain when the needles are inserted.
For more information, go to www.arthritisresearchuk.org.
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