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Shoulder Pathway

Shoulder Pathway. Differential diagnosis. Impingement. A/C Joint. Instability. Frozen Shoulder. Major Rotator Cuff Tear Sudden loss of abduction / ext rotation. Physiotherapy 6-12 weeks. Physiotherapy 6-12 weeks. Physiotherapy 12-18 weeks. Physiotherapy 3-6 months. Urgent.

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Shoulder Pathway

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  1. Shoulder Pathway Differential diagnosis Impingement A/C Joint Instability Frozen Shoulder Major Rotator Cuff Tear Sudden loss of abduction / ext rotation Physiotherapy 6-12 weeks Physiotherapy 6-12 weeks Physiotherapy 12-18 weeks Physiotherapy 3-6 months Urgent Steroid injection Steroid injection if still symptomatic Steroid injection if still symptomatic Neck* Thoracic* Elbow* Heart Gall Bladder Phrenic nerve** Neuropathic** Further Physiotherapy 3-6months Long term Instability? Consider referral Sympts for 6- 12 mths? 2 failed steroid Injects? Sympts for 6- 12 mths? 2+ failed steroid Injects? YES * Refer to Physio **Neurosurgery Refer for standard x-rayAxillary and outlet views IF SUSPECTING ARTHRITIS etc. GP/Physio Refer to orthopaedics - shoulder subspecialty Discharge Refer for POST OPERATIVE physiotherapy Further investigations; MRI, U/S, surgeryFurther Rx Steroid Inj +/- physio

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