Shoulder external rotators

Many patients also have decreased range of motion of the arm, constraining the set of postures into which they can self-attach their arms to a machine. Commonly affected degrees of freedom are forearm supination and shoulder external rotation. It is thus important to avoid having the patient maneuver his or her hand through a complex attachment geometry. The MIT-MANUS, the MIME, and the ARM Guide allow attachment of the hand in a pronated posture directly in front of the torso. 

SR = starting external rotation which allowed the shoulder to reach maximal elevation in the scapular plane ( 40° zb 8°) NA = not applicable. 

This test is for a chronically dislocating shoulder. The shoulder is abducted, extended, and externally rotated. A1 ihe point where ihe shoulder is about 10 dislocate, the patient will appear apprehensive. Many patients are already aware thai their shoulder dislocates spontaneously and will mention this in the history before the examination. 

If the dysfunction is lateral to the middle of the shoulder joint, the final motions are abduction and external rotation. 

Note The amount of flexion and whether abduction-external rotation or adduction-internal rotation is applied will follow the same notes as for the shoulder joint. 

Examination of the shoulder revealed no bruising, swelling, or inflammation. Motion of the right shoulder was restricted in comparison to the left in flexion, abduction, extension, and external rotation, both passively and actively. He was unable to perform the Apley scratch test fully. Muscle strength was relatively normal, although it was difficult to test because of pain. The neck, elbow, and wrist were normal on examination. There was marked tenderness to palpation ofthe biceps tendon and some tenderness of the supinator tendon. There was no tenderness or swelling of the bursa of the shoulder. 

There are three degree of freedom involved to construct this model represented by three angles qi, q2, and qs. Each angle represent three movement of the shoulder namely flexion/extension, adduction/abduction and external rotation/internal rotation. 

Erickson SJ (1997) High-resolution imaging ofthe musculoskeletal system. Radiology 205 593-618 Farin PU, Jaroma H, Harju A et al (1995) Medial displacement of the biceps brachii tendon evaluation with dynamic sonography during maximal external shoulder rotation. Radiology 195 845-848... 

After the biceps has been examined, the patient is asked to rotate the arm externally in order to evaluate the subscapularis tendon on the anterior aspect of the shoulder. This maneuver stretches the subscapularis and helps to move its tendon from underneath the coracoid process into a more superficial position for an adequate examination (Fig. 6.25). Dynamic scanning during passive internal and... 

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