Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive right shoulder pain, localized to the glenohumeral joint. Symptoms are exacerbated by overhead activity and internal rotation, with associated stiffness and mechanical symptoms including crepitus. Pain is worse with activity and improves slightly with rest. No history of acute trauma, instability, or neurological deficits.
Clinical Examination Findings
Right shoulder examination reveals atrophy of the supraspinatus and infraspinatus fossae. Tenderness to palpation noted over the glenohumeral joint line. Active and passive range of motion is significantly restricted in all planes, particularly abduction and external rotation. Crepitus is palpable during passive motion. Neurovascular status is intact distally.
Treatment Protocol
Initiate conservative management including activity modification, physical therapy focusing on range of motion and periscapular strengthening, and non-steroidal anti-inflammatory drugs (NSAIDs). Consider intra-articular corticosteroid or hyaluronic acid injection for symptomatic relief. Discuss surgical options, including arthroscopic debridement or total shoulder arthroplasty, if conservative measures fail.