title: Managing shoulder pain in general practice - assessment, imaging and referral.
abstract: BACKGROUND
  A case review was carried out on 112 cases of shoulder pain, referred for specialist attention. The general practitioner referral letter offered a diagnosis in 40% (45/112) of cases with 89% (40/45) of these concurring with the diagnosis made by the orthopaedic surgeon. Shoulder ultrasound had been ordered for 95/112 (85%) patients with 71/112 (63%) being combined with plain radiology.
  
  
  OBJECTIVE
  This article presents findings of a case review examining the management of shoulder pain in general practice.
  
  
  CONCLUSIONS
  The assessment of shoulder presentation suggests a lack of confidence by the referring practitioner due to the reliance on diagnostic ultrasound. Such practice can be unnecessarily expensive and would benefit from the establishment of guidelines for what imaging best suits the presenting complaint.
authors.affiliation: Orthopaedic Fellow, Sportsmed-SA, Adelaide, South Australia. p.johal@ic.ac.uk
authors.forename: Parm
authors.initials: P
authors.lastname: Johal
authors.forename: David
authors.initials: D
authors.lastname: Martin
authors.forename: Norman
authors.initials: N
authors.lastname: Broadhurst
mesh_terms: D000328:Adult; D003952:Diagnostic Imaging; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D012017:Referral and Consultation; D020069:Shoulder Pain / Q000175:diagnosis* / Q000209:etiology