LESIONS OF THE SHOULDER

Many patients complain of pain in the shoulder, but in any pain, diagnosis must precede treatment. Shoulder pain presents a diagnostic problem which must be approached by the routine path, the careful recording of the history of the patient, followed by physical examination and special investigation where necessary. I have recently found instances in which the patient's own complaint of shoulder pain has been accepted without investigation, and physical therapy has been directed to it although the primary cause of the pain has lain outside the shoulder. Similarly, I have read in a so-called textbook the statement that one should accept the syndrome of the painful shoulder without considering the underlying pathologic condition which is causing the pain and that he should prescribe treatment on this basis. Such a statement allows one to form an opinion of the author and his book.

The causes of shoulder pain can be divided