Diagnostic evaluation of athletes with posttraumatic chronic shoulder pain

We examined 20 consecutively admitted athletes suffering from chronic shoulder pain for more than 6 months following a single shoulder trauma without dislocation. All had pain during loading, especially during over-the-head activities with a clicking sensation, and symptoms of dead arm were also present. On examination, 8 patients had decreased range of motion and 14 patients had a positive apprehension test. Three had signs of impingement. Diagnostic evaluation with special X-ray, ultrasonography, magnetic resonance imaging (MRI) and arthroscopy identified IS lateral tears, 3 partial and 1 total rotator cuff lesions and 2 patients with synovitis of the rotator cuff with subacromial impingement. Three patients had tendinitis of the biceps tendon and 1 had a lesion of the greater tubercle. In conclusion, chronic shoulder pain after a single nondislocated shoulder trauma in athletes should be evaluated due to a possible intraarticular cause of the pain. MRI seems to be the most valuable noninvasive method of evaluating patients with chronic shoulder pain and should be performed before arthroscopy and operative procedures.