SHOULDER PAIN; DIAGNOSIS AND TREATMENT OF INJURIES TO SOFT TISSUES.

Many patients with injuries to the shoulder suffer prolonged disability, economic distress and psychological anguish because the diagnosis of their difficulties is made too late or not at all. Immobilization of an injured shoulder, whether by guarding on the part of the patient or as a part of treatment, can do permanent harm. Shoulder injuries involving soft tissue damage are more common than bony injury but the diagnosis is more difficult. In this group are included tears of tendons, capsular tears, acromioclavicular cartilage injuries, "frozen shoulders," and ligamentous damage. The application of roentgenographic techniques to outline soft tissue structures inside the joint by the use of water-soluble iodized dyes improves diagnostic accuracy. Pessimism as regards treatment of soft tissue damage in the shoulder region is frequently paralleled by inexperience.