Present occurrence of a morning stiffness, a restriction of motility2 of the shoulder girdle and pains in the shoulder girdle are typical symptoms of an inflammatory affection of the shoulder girdle.
The morning stiffness is often manifested as a symptom of
inflammatory affections (one of the diagnostic criteria of RA), and in our
opinion, it is a confirmation of frequent rheumatoid etiology of pains of
the shoulder (mainly tenovaginitis of the long head of the biceps).
The restriction of motility of the shoulder girdle. For
example it is typical situation that a patient is not able to button up a
bra, or a restriction of hygienic needs (as cleaning one's teeth, combing one's
hair) is also common at the localized affection of the shoulder
girdle (men do not complain of neither these restrictions).
Pains – which are typical at the localized affection of the shoulder girdle.
A muscular weakness which is not in the front at painful
states. In addition it is necessary to differentiate the primary muscular
weakness3, and the secondary weakness caused by pains in the
shoulder. The patient spares his/her limb, and he/she subconsciously does
not want to make any movement with the shoulder. Sudden development of
the weakness can occur at ruptures of the rotator cuff. In
differential diagnostics of ruptures it is necessary in this case to differ
the weakness caused by neurogenic affection. If the first thing
of patient's problems is the weakness, and pains are not so strong, it is a
question of neurogenic or muscular affection.
Sound phenomena and skipping of the joint in certain
positions can indicate a presence of instability
of the glenohumeral articulation. Patients rather ask about the meaning
of insignificant clicks which are not painful in the case of benignancy ,
they only annoy the patient with sound phenomena.
2a restriction in the extension of an active and a
3caused by myopathy or by neurogenic cause