Abstract
BackgroundShoulder pain is common in the general population. Reports on specific diagnoses in general populations are scarce and only from primary care. The diagnostic distribution of shoulder disorders in secondary care is not reported. Most of the clinical research in the shoulder field is done in hospital settings. The aim of this study was to identify the diagnoses in a 1-year cohort in a hospital-based outpatient clinic using standardized diagnostic criteria and to compare the results with previous studies.MethodsA diagnostic routine was conducted among patients referred to our physical medicine outpatient clinic at Oslo University Hospital. Diagnostic criteria were derived from the literature and supplemented with research criteria.ResultsOf 766 patients diagnosed, 55% were women and the mean age was 49 years (range 19–93, SD ± 14). The most common diagnoses were subacromial pain (36%), myalgia (17%) and adhesive capsulitis (11%). Subacromial pain and adhesive capsulitis were most frequent in persons aged 40–60 years. Shoulder myalgia was most frequent in age groups under 40. Labral tears and instability problems (8%) were most frequent in young patients and not present after age 50. Full-thickness rotator cuff tears (8%) and glenohumeral osteoarthritis (4%) were more prevalent after the age of 60. Few differences were observed between sexes. We identified three studies reporting shoulder diagnoses in primary care.ConclusionSubacromial pain syndrome, myalgia and adhesive capsulitis were the most prevalent diagnoses in our study. However, large differences in prevalence between different studies were found, most likely arising from different use of diagnostic criteria and a difference in populations between primary and secondary care. Of the diagnoses in our cohort, 20% were not reported by the studies from primary care (glenohumeral osteoarthritis, full thickness rotator cuff tears, labral tears and instabilities).
Highlights
Shoulder pain is common in the general population
Rotator cuff and labral tears rely mainly on reported pain and positive clinical tests to be confirmed as possible reasons for the patient’s pain, they are in some cases image supported [7]
The mean duration (± SD) of shoulder pain was 29 ± 42 weeks for men and 26 ± 38 weeks in women. 471 (61%) of the patients supplied a compact disc with a magnetic resonance imaging (MRI) scan or had a description of the scan attached to their referral letter
Summary
Shoulder pain is common in the general population. Reports on specific diagnoses in general populations are scarce and only from primary care. Walker-Bone et al [4] invited all persons with shoulder pain in a survey diagnoses in different studies These differences might be caused by the different populations examined and by the various sets of diagnostic criteria used. Most of the shoulder diagnoses are based on clinical criteria Diagnoses such as osteoarthritis, rotator cuff and labral tears rely mainly on reported pain and positive clinical tests to be confirmed as possible reasons for the patient’s pain, they are in some cases image supported [7]. Rotator cuff and labral tears rely mainly on reported pain and positive clinical tests to be confirmed as possible reasons for the patient’s pain, they are in some cases image supported [7] This is the case in persons aged over 60 years because of the natural and mostly pain-free changes in the tissue that come with age [8,9,10]
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