Clinical Examination of the Shoulder.

Clinical Examination of the Shoulder Ellenbecker TS. St Louis, MO, 63146, Saunders, 2004, paperback, 210 pp, illus, ISBN: 0-7216-9807-7, $39.95.

Clinical Examination of the Shoulder is a comprehensive review of the current research literature regarding the clinical examination, evaluation, and diagnosis of the shoulder complex. The goal of this text is to provide the clinician with updated information from the recent research literature on the reliability and validity of measurements produced by various tests of the shoulder complex. Throughout this text, the author provides the reader with evidence-based literature describing the sensitivity, specificity, reliability, validity, and predictive values of a comprehensive clinical examination of the shoulder. Definitions of exactly what constitutes a positive test and the ramifications of test findings also are discussed in detail.

The text's material is well organized and succinct. The book is divided into 3 main sections on general examination techniques, orthopedic special tests, and functional performance testing. A fourth section containing 3 case studies also is provided. In each section, the author provides the reader with adequate line drawings and original photographs that depict the anatomical structures being examined, and detailed instructions on how to carry out each component of the patient history and examination. Tables depicting examination findings, joint mobility scales, and classification schemes provide the clinician with a desk reference. Terminology is consistent with the Guide to Physical Therapist Practice.

This text differs from others on clinical examination and evaluation in several ways. First, other than the chapter on differential diagnosis and related referral joint testing, this text strictly focuses on the shoulder complex. This allows the author to provide a comprehensive examination primer for the shoulder. Second, this text provides the newest research on the examination of the shoulder complex. Many physical therapists will be interested in the current research findings on the classification of scapulothoracic joint dysfunction and the concept of total rotation range of motion in the glenohumeral joint. These topics are relatively new and, to the best of my knowledge, have been unavailable in a textbook format thus far. In addition, because the author cites the original and subsequent literature describing each special test, readers will learn each test's origins, reliability and validity of the measurements, and the extent to which each test can help form a clinical diagnosis. I found this text to be an excellent example of how to perform a clinical examination as part of evidence-based practice. By utilizing the statistics on sensitivity, specificity, and predictive ratios provided in the text, readers can develop a better understanding on how to design and improve their glenohumeral and scapulothoracic joint examination and clinical diagnostic skills.

Students or physical therapists requiring a reference on treatment techniques and suggested exercises for common shoulder disorders will have to go elsewhere for this information. This text is meant only to describe and illustrate the examination, evaluation, and clinical diagnosis portion of patient care. Interventions are not discussed. Educators will find the chapter on formulating a clinical diagnosis and the case studies to be useful tools for stimulating classroom discussions or course projects. The chapter on analysis of sports technique serves as a "how-to" manual for physical therapists working in sports medicine. Overall, I found this text to be an outstanding clinical resource and reference. Clinicians who evaluate and treat patients with shoulder disorders will find it beneficial.

James W Matheson, PT, MS, SCS, CSCS 

Therapy Partners Inc

Minneapolis, Minn

Mr Matheson is the Clinical Research Director and a sports-certified therapist for Therapy Partners Inc. He specializes in the examination and treatment of patients with upper- or lower-extremity musculoskeletal disorders.