Table 1

Specific disorders distinguished by the diagnostic algorithm

DisorderDefinition
Rotator cuff tendinitis

  1. Pain anywhere in the shoulder; plus

  2. Induced shoulder pain on either resisted external rotation, internal rotation or abduction, or a painful arc

Bicipital tendinitis

  1. Pain in the anterior shoulder region; plus

  2. Induced pain over the anterior shoulder on resisted elbow flexion or forearm supination

Shoulder capsulitis

  1. Pain anywhere in the shoulder; plus

  2. Deficit in active and passive movements for either abduction or external rotation or internal rotation. Deficits were defined as: <140° for abduction, <70° for external rotation and <90° for internal rotation

Acromioclavicular joint disorder

  1. Pain over the acromioclavicular joint; plus

  2. Tenderness over the acromioclavicular joint; plus

  3. A positive acromioclavicular joint stress test

Subacromial bursitis

  1. Pain over the subacromial bursa; plus

  2. Tenderness over the subacromial bursa

Lateral epicondylitis

  1. Pain over the lateral elbow; plus

  2. Tenderness over the lateral elbow; plus

  3. Induced pain over the lateral elbow on resisted wrist extension

Medial epicondylitis

  1. Pain over the medial elbow; plus

  2. Tenderness over the medial elbow; plus

  3. Induced pain over the medial elbow on resisted wrist flexion

Olecranon bursitis

  1. Pain over the posterior elbow; plus

  2. Tenderness over the posterior elbow; plus

  3. Fluid filled swelling over the posterior elbow

Carpal tunnel syndrome

  1. Pain or sensory symptoms in median nerve distribution or sensory loss in the median nerve distribution (impairment of light touch in thumb and index but not little finger) or hand pain; plus

  2. At least one of:

    • positive Tinel’s sign

    • positive Phalen’s test

    • motor loss (wasted thenar eminence or weakness of thumb abduction or weakness of thumb opposition)

    • disturbed sleep in the past 7 days due to numbness or tingling in the arms or hands

Tenosynovitis

  1. Pain over the dorsal wrist plus induced pain over the dorsal wrist on resisted finger extension; or

  2. Pain over the palmar wrist plus induced pain over the palmar wrist on resisted finger flexion; or

  3. Pain over the ulnar aspect of the wrist plus induced pain over the ulnar aspect of the wrist on resisted ulnar flexion of the wrist; or

  4. Pain over the radial aspect of the wrist plus induced pain over the radial aspect of the wrist on resisted radial flexion of the wrist, in the absence of De Quervain’s disease of the wrist

De Quervain’s disease of the wrist

  1. Pain over the radial aspect of the wrist; plus

  2. Tenderness over the radial aspect of the wrist; plus

  3. Pain on resisted thumb extension or a positive Finkelstein’s test