Painful shoulder: comparison of physical examination and ultrasonographic findings.

Background: High frequency ultrasonography is an accurate non-invasive imaging technique for evaluating patients with painful shoulder.

Objective: To compare the clinical diagnosis established by a physical examination with high frequency ultrasonographic findings in patients with painful shoulder.

Methods: Thirty one consecutive patients with a first flare of shoulder pain were prospectively included in the study. All had a physical examination performed by two blinded rheumatologists. Ultrasonographic examination was carried out within one week of the physical examination by a third rheumatologist experienced in this technique who had no knowledge of the clinical findings. Ultrasonography was considered the optimal diagnostic technique.

Results: Clinical assessment showed low accuracy in the diagnosis of periarticular shoulder lesions.

Conclusion: Ultrasonography should be used wherever possible to improve diagnosis and treatment of painful shoulder.