Pediatric Orthopedic Physical Examination of the Infant: A 5-Minute Assessment

Shoulders and Elbows

Shoulders

Limited range of motion could indicate the extremely rare congenital dislocation of the shoulder, or of a more generalized problem such as arthrogryposis in which the shoulders are usually fixed in adduction and internal rotation, or of Sprengel deformity of the scapula (Leibovic et al., 1990).

Elbows

Limited range of motion could suggest amyloplasia or arthrogryposis, in which the elbows are often fixed in flexion or extension. Palpate the radial head while pronating and supinating the forearm, feeling for congenital dislocation of the radial head, or even neglected or undiagnosed Monteggia fracture. Absent or markedly reduced pronation and supination of the forearm could indicate a synostosis between the radius and ulna.

J Pediatr Health Care. 2003;17(1) © 2003  Mosby, Inc.

Cite this: Pediatric Orthopedic Physical Examination of the Infant: A 5-Minute Assessment - Medscape - Jan 01, 2003.