In the broader text, the meaning of “broken” has multiple possibilities. Fracture is the term for a broken bone (always gets an x-ray). The surgeon will likely know the diagnosis simply from taking a good history leading up to the problem or complaint. The diagnostic devices, including: physical examination (appearance and feel), diagnostic ultrasound, MRI, x-ray, CAT scan, are meant to confirm the diagnosis. Any patient has a right for concern if the surgeon doesn’t spend the time first questioning (history) and then touching, before requesting the “machine tests”. When it is an acute emergency, a triage procedure kicks in. In either event it is a check list of sorts. (read “Checklist Manifesto” by Atul Gawande).
When making a decision do you go to your PCP, a family member or friend, school trainer or infirmary, coach, the internet, or directly refer yourself to an orthopedic surgeon or physical therapist?
If it isn’t an emergency, you might search the internet before any other sources. Then search again after your professional orthopedic consultation to elaborate on the information you received.
The shoulder has three joints: gleno-humeral, acromio-clavicular, and sterno clavicular. Sometimes the scapula thoracic is referred to as a fourth joint. The shoulder has many specialized tissues (ligament, tendon, muscle, bone, vascular, and nerves.)
Some common possibilities might include: separated shoulder, rotator cuff tendinitis or tear, TOS, bone spur, bursitis, labral tear, adhesive capsulitis, complex regional pain syndrome, …?
The surgeon may think about and ask you questions. What part of the shoulder could have gotten injured with the history of mechanism? A fall, a grab, a twist? What domestic, sport, or work activity or maneuver? Is it a sharp, dull, achy, electric, or burning pain? Is it referred pain (a what?) or point specific? Can you go to work? You may be aware of sports arenas using cameras on playing fields for use in helping to determine the mechanism of injury when one occurs. Even though the doctor has the examination skills to differentiate much of the shoulder pathologies, the x-ray, CAT scan, or MRI may reveal it isn’t broken, just roughed up.
Just because your shoulder is painful or has a pain, doesn’t mean it requires any more treatment than some rest (maybe ice, OTC medication, or heat too). Our bodies usually “tell” us when to see a doctor. Some of us are too fast inserting ourselves into the healthcare system, some too slow, but most of us “just right”.
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