DIAGNOSTIC OF SHOULDER PROBLEMS

Shoulder diagnostics: methods, procedures and modern examination techniques

Why is diagnosis so important for shoulder problems?

Shoulder pain has many possible causes—from tendon irritation to cartilage damage to bone fractures. Precise diagnosis is crucial to initiating the correct treatment . This reveals which structures are affected and which therapy has the best chance of success.

Central components of shoulder diagnostics are:

1. The detailed patient interview (anamnesis)

2. The physical examination

These basic principles are supplemented by various instrumental procedures that are used specifically when a suspicion needs to be confirmed or an injury needs to be assessed more precisely.

Why is clinical examination important for shoulder problems?

The clinical examination is a key component of shoulder diagnostics. Through palpation, movement tests, and functional assessments, doctors can often identify affected structures early on. This provides crucial information not always visible on MRI or X-rays and forms the basis for appropriate treatment.

What instrumental examinations are available for shoulder problems?

Diagnosis of shoulder problems includes a patient interview, physical examination, and imaging procedures such as X-rays, ultrasound, MRI, or CT. Arthroscopy and nerve measurements (ENG/EMG) can also be used to identify causes of pain and instability.

Overview of shoulder diagnostic methods

Ultrasound (sonography)

Ultrasound is a fast, painless, and radiation-free procedure. It is particularly suitable for assessing tendons, muscles, and ligaments . Typical findings:

• Rotator cuff tear

• Tendonitis

• Bursitis

Magnetic resonance imaging (MRI)

MRI provides detailed cross-sectional images of soft tissue and cartilage . It is the procedure of choice for:

• Rotator cuff injuries

• Labral tears

• Ligament damage

• Cartilage and joint capsule injuries

Advantage: highest accuracy for soft tissues. Disadvantage: longer examination time and not suitable for all patients (e.g., those with metal implants).

X-ray

Classic X-ray diagnostics primarily reveal bone structures. Typical findings:

• Fractures (e.g. humeral head, glenoid fossa)

• Signs of osteoarthritis

• Misalignments or deformities

Advantage: fast and cost-effective. Disadvantage: no soft tissue imaging.

Computed tomography (CT)

CT provides high-resolution cross - sectional images of bones. Areas of application:

• Complex fractures

• Preparation for operations

• Alternative if MRI is not possible

Disadvantage: higher radiation exposure than with X-rays.

Arthroscopy

Arthroscopy is a minimally invasive examination of the joint. A camera is inserted through small incisions, allowing a view into the joint. Advantages :

• highest accuracy (“gold standard”)

• Diagnosis and treatment are possible simultaneously (e.g. tendon suture, labrum refixation)

Electroneurography (ENG) and electromyography (EMG)

Not all shoulder problems originate in the joint itself. ENG and EMG can measure nerve conduction and muscle activity .

• Used when nerve compression or neurological causes of shoulder pain are suspected .

Diagnostic process: From conversation to high-tech

1. Patient interview (anamnesis) : When does the pain occur? Has there been an accident? Which movements aggravate the symptoms?

2. Physical examination : palpation, mobility testing, special functional tests.

3. Targeted imaging : ultrasound, X-ray, MRI or CT depending on the question.

4. Further procedures : arthroscopy or nerve measurements for specific questions.

   
   

For whom is sports medicine performance diagnostics useful?

Sports medicine performance diagnostics go beyond pure shoulder diagnostics and are aimed primarily at people who are physically active.

It is used to examine the cardiovascular system and musculoskeletal system under stress and to determine individual fitness for sport .

Typical components:

• Medical history and family history

• Full body examination

• Stress ECG and spirometry

• Determination of VO₂max and anaerobic threshold

👉 Useful for:

• Recreational athletes who want to train safely

• Competitive athletes who want to optimize their training plans

• Patients after shoulder injuries who want to return to sport

Advantages of performance diagnostics

• Early detection of diseases

• Individual training control

• Injury prevention through targeted exercise recommendations

• Safe return after injury

Precise diagnostics as the basis for the right treatment

Without thorough diagnostics, the cause of shoulder problems often remains unclear. Only once it's clear whether tendons, ligaments, cartilage, nerves, or bones are affected can a tailored treatment plan be developed.

In Prof. Ockert’s practice we combine:

• modern imaging

• experienced examination by specialists

• individual advice

This way we can find the cause of your symptoms and accompany you back to freedom from symptoms with the appropriate therapy.

👉 Make an appointment now – we will clarify the cause of your shoulder pain.