Managing shoulder pain in general practice: Assessment, imaging and referral

BACKGROUND: A case review was carried out on 112 cases of shoulder pain, referred for specialist attention. The general practitioner referral letter offered a diagnosis in 40% (45/112) of cases with 89% (40/45) of these concurring with the diagnosis made by the orthopaedic surgeon. Shoulder ultrasound had been ordered for 95/112 (85%) patients with 71/112 (63%) being combined with plain radiology. OBJECTIVE: This article presents findings of a case review examining the management of shoulder pain in general practice. DISCUSSION: The assessment of shoulder presentation suggests a lack of confidence by the referring practitioner due to the reliance on diagnostic ultrasound. Such practice can be unnecessarily expensive and would benefit from the establishment of guidelines for what imaging best suits the presenting complaint. (author abstract)