Shoulder joint examination – visual examination The height of the shoulder and scapula should be noted and compared posteriorly, on both sides. The shoulder is rounded and can become square after dislocation, hence the term square shoulder. Patients with congenital high scapula are significantly higher on the affected side than on the healthy side. Paralysis of the trapezius muscle presents as a drooping shoulder with a slightly elevated internal superior scapular angle. Anterior serratus paresis presents as a winged scapula when the upper limb is raised forward and flat. Shoulder joint examination – palpation The stability of the mengohumeral, acromioclavicular and sternoclavicular joints should be clarified. The full length of the clavicle can be palpated subcutaneously; when examined posteriorly in the patient, a comparison between the two sides can be made. The rostral end of the scapula, the acromion end and the greater tuberosity of the humerus form a normal shoulder triangle, which can be used to check the normal relationship of the shoulder joint. If there is a fracture or dislocation, the shoulder triangle will be abnormal. Common pressure points in the shoulder Inter-nodal groove – biceps long head tenosynovitis Greater humeral tuberosity – supraspinatus tendon injury.