Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Palpation of the supraspinatus muscle

Muscle belly and musculotendinous junction. The subject sits with the arm in full abduction and rested on the couch. The elbow now lies on the same level as the shoulder. The examiner stands behind the subject. The trapezius muscle is well relaxed and palpation can be performed through that muscle. Palpate for the spine of the scapula.

The muscle belly lying just above the spine of the scapula is the supraspinatus muscle. It fills up the supraspinous fossa. Move the palpating finger more laterally until it reaches the corner formed
between the clavicle and the spine of the scapula.The finger now Hes on the musculotendinous junction of the supraspinatus, which can be felt to continue laterally under the acromion .

Insertion on the greater tuberosity. Now position the subject with the forearm behind the back. The arm is now in full internal rotation. Palpate for the lateral border of the acromion; follow it in the
anterior direction until the corner is felt between the lateral and anterior border and identify the latter. Also look for the acromioclavicular joint and keep the palpating finger lateral to it. Move
the finger forwards so that it comes to He on the greater tuberosity of the humerus but is still in contact with the acromion as well. Exert a pressure vertically downwards against the humerus.

The finger now lies on the supraspinatus tendon of which the medial border can be felt quite clearly.Palpation of the Infraspinatus muscle.The subject is in prone lying and rests on the elbows. The upper arm should be kept vertical and in slight adduction. The subject therefore leans towards the shoulder to be palpated. With the hand he grasps the edge of the couch. This results in some external rotation of the shoulder as well. The examiner looks for the spine of the scapula and palpates below it, in the infraspinous fossa. The thumb now lies on the infraspinatus muscle belly. Place the thumb just under the
spine of scapula and palpate more and more laterally. A tendon will be felt that runs parallel to this spine. This is the infraspinatus tendon.

It can be followed until the attachment on the greater tuberosity is found. The bone can be felt through the tendinous mass. Palpate more laterally until the thumb lies on the greater tuberosity.The tendinous structure cannot be felt any more.Come back to the previous point where both bone and tendon are felt. This is the insertion.

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