Painful shoulder: comparison of physical examination and ultrasonographic findings.

Abstract

High frequency ultrasonography is an accurate non-invasive imaging technique for evaluating patients with painful shoulder. To compare the clinical diagnosis established by a physical examination with high frequency ultrasonographic findings in patients with painful shoulder. Thirty one consecutive patients with a first flare of shoulder pain were prospectively included in the study. All had a physical examination performed by two blinded rheumatologists. Ultrasonographic examination was carried out within one week of the physical examination by a third rheumatologist experienced in this technique who had no knowledge of the clinical findings. Ultrasonography was considered the optimal diagnostic technique. Clinical assessment showed low accuracy in the diagnosis of periarticular shoulder lesions. Ultrasonography should be used wherever possible to improve diagnosis and treatment of painful shoulder.