Differentiating cervical spine and shoulder pathology: common disorders and key points of evaluation and treatment.

Accurately diagnosing patients with self-described pain in the shoulder or cervical spine (neck) remains a challenge for the orthopaedic surgeon. The overlapping presentations of shoulder disorders with those of the cervical spine, along with a lack of precision in physical examination testing, can create a confusing clinical picture and may result in disorganized or ineffective diagnostic and treatment regimens. A careful physical examination combined with judicious use of adjunctive tests, including selective corticosteroid injections, may help clarify the diagnosis. A high index of suspicion for the presence of cervical spine pathology is recommended in patients presenting with shoulder pain and vice versa.