Diffusive Pains in the Area of the Shoulder Girdle

Diffusive pains in the area of the shoulder girdle are such pains for which we do not find a positive explanation of their cause by examining methods as MRI, arthroscopy, X-ray or ultrasound. (But the ultrasound examination is not considered to be a sufficient  tentative examination which will eliminate a serious located affection of soft tissues1).

 

Clinical Picture of Diffusive Pains of the Shoulder Girdle

  1. A localization of pains is diffusive, a patient cannot localize the pains into one place.

  2. Pains annoy rather with their chronicity  than intensity (at these pains of course exceptions exist e. g. acute radicular syndromes of the cervical spine).

  3. Pains are often connected to a certain movement, and they are evoked only in a certain position. The patient mostly tries to do the movement several times until he does the one which evokes the pain.

  4. A restriction of the extension of the movement is minimal or is not present.

  5. An isometric contraction is not very weakened, its soresness very often occurs.

  6. A morning stiffness, a reinforcement of pains at night and during lying on the affected side (showing that there is an inflammatory affection) are not there.

 

 

Areas with the Most Frequent Occurrence of Diffusive Pains of the Shoulder Girdle 

  1.  attachments of muscles of the shoulder girdle to the humerus (mainly in the area of m. deltoideus)

  2. labrum glenoidale posterior

  3. m. trapezius, m. supraspinatus in the whole course

  4. attachments of muscles to the scapula

  5. a thoracal and cervical spine paravertebrally

  6. an acromion

 

picture of the localization of diffusive pains in the area of the shoulder girdle

1 an exception is formed by an anamnesis of accidental etiology where with regarding to SLAP syndrome and possibility of an affection of the joint in the place, which is not accessible for ultrasound examination, we continue also in other examinations as MRI or arthroscopy.