What should be the focus of patient history in the evaluation of supraspinatus tendonitis?

Updated: Dec 04, 2017
  • Author: Thomas M DeBerardino, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

See the list below:

  • Age

    • Younger than 40 years: It is usually glenohumeral instability. The cause is acromioclavicular joint disease or injury.

    • Older than 40 years: Consider glenohumeral impingement syndrome or rotator cuff tendonitis. Additionally, consider degenerative joint disease of the glenohumeral joint.

  • Occupation

    • Laborers and persons with jobs that require repetitive overhead activity (most at risk).

    • Athletes (eg, swimmers, those participating in throwing sports, tennis players, volleyball players)

  • Athletic activity

  • Onset of symptoms related to specific phases of the athletic event performed

  • Duration and frequency of play

  • Duration and frequency of practice

  • Level of play (Little League [elementary school], middle school, high school, college, professional)

  • Actual playing time (starter, backup, bench player)

  • Position played

  • Symptom onset

    • Sudden onset of sharp pain in the shoulder with tearing sensation - More suggestive of a rotator cuff tear

    • Gradual increase in shoulder pain with overhead activities - More suggestive of an impingement problem

  • Chronicity of symptoms

  • Location of symptoms (ie, pain)

    • Usually lateral, superior, anterior shoulder; occasionally referred to deltoid region

    • Posterior shoulder capsule - Usually consistent with anterior instability causing posterior tightness

  • Setting during which symptoms appear (eg, pain during sleep or various sleeping positions, at night, with activity, types of activities, at rest)

  • Quality of pain (eg, sharp, dull, radiating, throbbing, burning, constant, intermittent, occasional)

  • Severity of pain (ie, on a scale of 1-10, with 10 being the worst)

  • Alleviating factors (eg, change of position, medication, rest)

  • Aggravating factors (eg, change of position, medication, increase in practice, increase in play, change in athletic gear, change in position played)

  • Associated manifestations (eg, chest pain, dizziness, abdominal pain, shortness of breath) - May indicate a more ominous problem than supraspinatus tendonitis

  • Provocative positions

    • Pain with humerus in forward flexed and internally rotated position - Suggestive of rotator cuff impingement

    • Pain with humerus in abducted and externally rotated position - Suggestive of anterior glenohumeral instability and laxity

  • Other history - Previous or recent trauma, stiffness, numbness, paresthesias, clicking, catching, weakness, crepitus, symptoms of instability, neck symptoms


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