GP Vivas · musculoskeletal-presentations
Shoulder pain — structured viva
Structured oral on shoulder pain: age-pattern diagnosis, examination test accuracy limits, exercise-first rotator cuff care, GRASP injection evidence, placebo-surgery decompression trials, adhesive capsulitis phases and referral triggers.
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Study tools
Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'A colleague sends every shoulder for ultrasound and half to the surgeon — talk me through what you do instead.' The viva branches through pattern diagnosis, examination accuracy, exercise evidence, injection evidence and referral triggers.
Stem
You are the GP. A colleague refers every shoulder pain for ultrasound before review. [4]
References9ShowHide
- [1]Carette S et al. Intraarticular corticosteroids, supervised physiotherapy, or a combination of the two in the treatment of adhesive capsulitis of the shoulder. Arthritis & rheumatism, 2003.PMID 12632439
- [2]Ryans I et al. A randomized controlled trial of intra-articular triamcinolone and/or physiotherapy in shoulder capsulitis. Rheumatology (Oxford), 2005.PMID 15657070
- [3]Shaffer B et al. Frozen shoulder. A long-term follow-up. The Journal of bone and joint surgery. American volume, 1992.PMID 1624489
- [4]Hegedus EJ et al. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. British journal of sports medicine, 2012.PMID 22773322
- [5]Beard DJ et al. Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW). The Lancet, 2018.PMID 29169668
- [6]Paavola M et al. Subacromial decompression versus diagnostic arthroscopy for shoulder impingement. BMJ, 2018.PMID 30026230
- [7]Naunton J et al. Effectiveness of progressive and resisted and non-progressive or non-resisted exercise in rotator cuff related shoulder pain. Physical therapy in sport, 2020.PMID 32571081
- [8]Hopewell S et al. Progressive exercise compared with best-practice advice, with or without corticosteroid injection, for rotator cuff disorders: the GRASP factorial RCT. Health technology assessment, 2021.PMID 34382931
- [9]Kanto K et al. Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome: 10 year follow-up of the FIMPACT randomised, placebo surgery controlled trial. BMJ, 2025.PMID 41330610