How is atraumatic shoulder instability diagnosed?
A thorough history and physical examination are the keys to the diagnosis and treatment of MDI (Multidirectional Instability). The classic findings are: • a history of generalized laxity. • no history of a forceful dislocation event. • a history of recurrent episodes of instability. The patient’s history may reveal a recent injury, an obvious dislocation, or a change in sport or training that has led to instability in a previously healthy shoulder. A general examination of joint mobility is very helpful. By moving the arm around in several positions, the doctor can evaluate full shoulder motion. Multidirectional laxity may be present in both shoulders even though only one may be bothersome to the patient. A patient with MDI has an increase in glenohumeral translation (shoulder joint movement) in multiple directions, and symptoms can be recreated in one or more directions. More than 2 cm of movement during the sulcus test suggests the presence of MDI. The diagnosis of MDI should be base
