Shoulder: what the orthopaedic doctor needs to know.

Diagnosing shoulder pathology accurately requires both clinical expertise and the ability to interpret and correlate radiographic studies. Variational anatomy of the shoulder combined with the complexity of physical examination makes this difficult. Physical examination of the shoulder often leaves the surgeon with more than one working diagnosis. Imaging studies of the shoulder are more valuable if used to confirm a working diagnosis as opposed to reading the study in a vacuum. Clinical correlation should also be considered for any and all findings on an imaging study. Collaboration of the surgeon and the radiologist is essential in reducing the number of over-reported findings that are clinically insignificant. The surgeon should directly communicate with the radiologist as to his or her working diagnosis and the goal of the study. In this way the surgeon and radiologist become superior diagnosticians.