SHOULDER JOINT ASSESSMENT FORM 
REASON | EXISTS | DURATION (in days) |
|---|---|---|
| PAIN | ||
| DIFFICULTY IN LIFTING | ||
| DISLOCATION | ||
| SLEEPLESS NIGHTS | ||
| SWELLING |
TYPE OF TENDERNESS | RESULT |
|---|---|
| ANGLE OF ACROMION | |
| STERNO CLAVICULAR JOINT | |
| A-C JOINT | |
| BICIPITL GROOVE | |
| SPINE OF SCAPULA | |
| G-T OF THE HUMERUS |
TEST NAME | RESULT | |
|---|---|---|
LEFT | RIGHT | |
| FRENCH HORN SHOULDER TEST | ||
| LIFT OFF SUBSCAPULARIS TEST | ||
| EMPTY CAN TEST | ||
| FULL CAN TEST | ||
| DROP ARM SIGN | ||
| SPEEDS TEST | ||
| YERGASON TEST | ||
| ROTATOR CUFF TRIAD TEST | ||
TEST NAME | RESULT | |
|---|---|---|
LEFT | RIGHT | |
| APPREHENSION | ||
| SHOULDER CROSSOVER MANNEOUVER | ||
| SULCUS SIGN | ||
TEST NAME | RESULT | |
|---|---|---|
LEFT | RIGHT | |
| NEER TEST | ||
| HAWKINS TEST | ||
| EMPTY CANS TEST | ||
TEST NAME | RESULT | |
|---|---|---|
LEFT | RIGHT | |
| SPEED TEST | ||
| YERGASON TEST | ||
| OBRIENS TEST | ||
| LABRAL CRANK TEST | ||
TEST NAME | RESULT | |
|---|---|---|
LEFT | RIGHT | |
| RADIAL PULSE | ||
TEST NAME | RESULT | |
|---|---|---|
LEFT | RIGHT | |
| DISTAL CAPILLARY REFILL | ||
TEST NAME | ||||
|---|---|---|---|---|
LEFT | RIGHT | |||
ACTIVE | PASSIVE | ACTIVE | PASSIVE | |
| FORWARD FLEXION | ||||
| ABDUCTION | ||||
TEST NAME | ||||
|---|---|---|---|---|
LEFT | RIGT | |||
ACTIVE | PASSIVE | ACTIVE | PASSIVE | |
| EXTERNAL ROTATION | ||||
| INTERNAL ROTATION | ||||
TEST NAME | RESULT | |
|---|---|---|
LEFT | RIGHT | |
| GLOBAL RANGE OF MOTIONS | ||
TEST NAME | RESULT | |
|---|---|---|
LEFT | RIGHT | |
| WINGINGS OF SCAPULA | ||
TEST NAME | RESULT | |
|---|---|---|
LEFT | RIGHT | |
| MUSCLE WASTING | ||
TEST NAME | RESULT | |
|---|---|---|
LEFT | RIGHT | |
| AXILLARY NERVE | ||
| RADIAL NERVE | ||
| ULNAR NERVE | ||
| MEDIAN NERVE | ||
TEST NAME | RESULT | |
|---|---|---|
LEFT | RIGHT | |
| AXILLARY NERVE | ||
| RADIAL NERVE | ||
| ULNAR NERVE | ||
| MEDIAN NERVE | ||