- Infection – suspected joint infection needs same day emergency referral.
- Unreduced Dislocation – needs same day emergency referral.
- Suspected Tumour & Malignancy – needs urgent referral under 2WW (2 week wait) cancer pathway.
- Acute Rotator Cuff Tear as a result of a traumatic event needs urgent referral. (ideally should be seen in the next available specialist shoulder clinic)
40% of patients over the age of 40 years suffering from a traumatic anterior glenohumeral dislocation will have a rotator cuff tear. Not all of these will be clinically relevant but refer urgently if weak. The presence of infraspinatus weakness may indicate a large acute tear.
Noorani et al 2019 – Atraumatic Shoulder Instability