Assessment of the acutely injured shoulder

Trauma of the shoulder encompasses a wide range of potential injuries. The shoulder forms the articulation between the upper limb and trunk, with a close anatomical relationship to the neck and brachial plexus. Acute injuries can have large overlaps of presenting symptoms and many of the special tests we use are imperfect, and must be applied and interpreted in the context of the injury. It is important that a holistic approach is taken to the assessment of acutely injured shoulders in order to ensure injuries are adequately recognized and to guide appropriate further investigations and management. The purpose of this article is to provide a systematic approach to assessment of acute shoulder injuries and summarize the evidence base for special clinical tests that aid in diagnosis.