Role of clinical examination in conjunction with ultrasonography in diagnosing the case of painful shoulder

Background: Shoulder pain is a common musculoskeletal complaint with diverse etiologies, necessitating accurate diagnostic approaches. The current study evaluates the role of clinical examination in conjunction with ultrasonography (USG) in diagnosing a painful shoulder. Aims and Objectives: The primary objective was to determine the causes of shoulder pain identified through clinical examination and correlate them with USG findings. The secondary objective was to compare the diagnostic accuracy of clinical examination with high-resolution USG in assessing shoulder pathologies. Materials and Methods: The study included 90 patients aged 18–75 years presenting with shoulder pain at the Orthopedics Outpatient Department of Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh. Clinical assessment included inspection, palpation, and various functional tests, while USG utilized a 7.5 MHz linear phased array transducer to evaluate the rotator cuff, biceps tendon, and subacromial-subdeltoid bursa. Results: The majority of patients belonged to the 41–60 age group, with a nearly equal gender distribution. Clinical examination identified rotator cuff pathology as the most common condition (26.7%), followed by impingement syndrome (23.3%). USG demonstrated higher diagnostic accuracy, particularly for rotator cuff tears (90.5% sensitivity, 91.5% specificity) and supraspinatus tendinopathy (89.0% sensitivity, 92.5% specificity). Impingement syndrome (24.4%) and adhesive capsulitis (17.8%) were the most prevalent diagnoses. The findings reinforce the complementary roles of clinical examination and USG in achieving precise diagnoses. Conclusion: Clinical exam plus ultrasound improves shoulder diagnostics. Clinical assessment is a practical first-line screen, while ultrasound offers higher sensitivity and specificity for soft tissue lesions. Their integration enhances accuracy and guides effective patient management.