Clinical assessment of upper extremity injury outcomes.

PATIENT SCENARIO: The patient presented is a high school baseball pitcher who was unable to throw because of shoulder pain. He subsequently failed nonoperative management but was able to return to pitching after surgery and successful rehabilitation. CLINICAL OUTCOMES ASSESSMENT: The Disabilities of Arm, Shoulder and Hand (DASH) and the Pennsylvania Shoulder Score (PENN) were selected as clinical outcome assessment tools to quantify the patient's perceived ability to perform common daily tasks and sport tasks and current symptoms such as pain and patient satisfaction. CLINICAL DECISION MAKING: The DASH and PENN provide important information that can be used to target specific interventions, set appropriate patient goals, assess between-sessions changes in patient status, and quantify patients' functional loss. CLINICAL BOTTOM LINE: Best clinical practice involves the use of clinical outcome assessment tools to garner an objective measure of the impact of a patient's disease process on functional expectations. This process should facilitate a patient-centered approach by clinicians while they select the optimal intervention strategies and establish prognostic timelines.