An assessment of the interexaminer reliability of tests for shoulder instability.

Accurate noninvasive clinical tests of shoulder instability are important in assessing and planning treatment for glenohumeral joint instability. An interexaminer agreement trial was undertaken to estimate the reliability of commonly used clinical tests for shoulder instability. Thirteen patients with a history suggestive of instability, who had been referred to a shoulder specialist for treatment of their symptomatic shoulders, were examined by four examiners of differing experience.

The unstable shoulder in the adolescent athlete.

Shoulder dislocation and subluxation occur frequently in athletes, with peaks in the second and sixth decades. The majority of traumatic dislocations are in the anterior direction. The most frequent complication of shoulder dislocation is recurrence--a complication that occurs much more often in the adolescent population.

Clinical examination of the unstable shoulder.

The clinical history is usually a very helpful guide for identifying frank traumatic glenohumeral joint dislocations. Glenohumeral dislocation most commonly occurs in the anterior direction (>95%) with the shoulder forcibly abducted and externally rotated. Atraumatic, multidirectional and subtler glenohumeral instability are often harder to diagnose.