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OBJECTIVES: The purpose of this study was to develop the Avoidance of Daily Activities Photo Scale (ADAP Shoulder Scale) to measure shoulder pain-related avoidance behavior in patients with shoulder pain and evaluate and report the structural validity and internal consistency of the scale. METHODS: Potential daily activities involving the shoulder were selected from the activities and participation domain of the International Classification of Functioning, Disability and Health. The selected activities were presented to an expert panel, health care professionals, and patients with shoulder pain with the question "How much do you think it is important to ask patients with shoulder pain about this activity?" Activities attaining a content validity index (CVI) ≥ 0.8 were represented using a digitally colored photograph. Activity photographs were evaluated by health care professionals and patients with shoulder pain. Photographs with a CVI ≥ 0.8 were included in the scale. To evaluate structural validity and internal consistency of the scale, exploratory factor analysis was performed to determine the presence of any scale domain. Cronbach alpha was calculated to indicate the internal consistency of each domain. RESULTS: Of the 107 preselected activities, 21 attained a CVI ≥ 0.8. Eighteen photographs (CVI ≥ 0.8) were included in the scale after being analyzed by 120 health care professionals and 50 patients with shoulder pain. Exploratory factor analysis (N = 156) showed that the ADAP Shoulder Scale consists of 3 domains: free movement, high effort, and self-care. The internal consistencies of the domains were 0.92, 0.89, and 0.92, respectively. CONCLUSION: The ADAP Shoulder Scale included 15 photographs distributed in 3 domains. All domains had a high internal consistency. The scale is easily applicable, well understood, and relevant for shoulder pain. IMPACT: The ADAP Shoulder Scale can be used to rate shoulder pain-related avoidance behaviors. ispartof: Physical Therapy vol:102 issue:2 pages:1-30 ispartof: location:United States status: published

The present report describes a case where typical findings of traumatic glenohumeral interposition of rotator cuff stumps were surgically confirmed. This condition is a rare complication of shoulder trauma. Generally, it occurs in high-energy trauma, frequently in association with glenohumeral joint dislocation. Radiography demonstrated increased joint space, internal rotation of the humerus and coracoid process fracture. In addition to the mentioned findings, magnetic resonance imaging showed massive rotator cuff tear with interposition of the supraspinatus, infraspinatus and subscapularis stumps within the glenohumeral joint. Surgical treatment was performed confirming the injury and the rotator cuff stumps interposition. It is important that radiologists and orthopedic surgeons become familiar with this entity which, because of its rarity, might be neglected in cases of shoulder trauma. Resumo O objetivo deste trabalho é relatar um caso com os achados de imagem característicos da lesão traumática do manguito rotador com interposição de múltiplos cotos de tendões do manguito rotador entre a glenoide e o úmero, confirmada cirurgicamente. Esta condição é uma rara complicação do trauma do ombro. Em geral ocorre no trauma de alta energia, frequentemente associada com luxação da articulação glenoumeral. No caso em questão não houve documentação de luxação franca da articulação glenoumeral. As radiografias mostraram aumento do espaço articular, rotação interna do úmero e fratura do coracoide. Nas imagens de ressonância magnética, além das alterações observadas nas radiografias, foi identificada ruptura massiva do manguito rotador com interposição dos cotos dos tendões do supraespinal, do infraespinal e do subescapular no interior da articulação glenoumeral. Foi realizado tratamento cirúrgico confirmando a lesão e a interposição dos cotos do manguito. É importante que radiologistas e ortopedistas estejam familiarizados com esta entidade, que, pela sua raridade, pode ser negligenciada no atendimento do trauma do ombro.