If there is a history of shoulder pain, ask the patient to point to the painful area. The location of the pain may provide clues as to its origin:

■ Top of the shoulder, radiating toward the neck—acromioclavicular joint

■ Lateral aspect of the shoulder, radiating toward the deltoid insertion— rotator cuff

■ Anterior shoulder—bicipital tendon

Now identify the bony landmarks of the shoulder and then palpate the area of pain. Locate the acromion process and press medially to locate the distal tip of the clavicle at the acromioclavicular joint. Palpate laterally and down a short step to the greater tubercle of the humerus, and then press medially to locate the coracoidprocess of the scapula. Next palpate the painful area and identify the structures involved.

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