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©2013 UpToDate ® Print Email Age-related causes and clinical characteristics of intrinsic shoulder pain Age Disorder Clinical characteristics Adolescents and young adults Overuse injuries Pain and loss of function associated with a particular athletic activity Acromioclavicular sprain Focal pain over acromioclavicular joint; history of trauma Shoulder instability Minor trauma, high risk of recurrence Middle-aged and older individuals Rotator cuff tendinopathy or impingement syndrome Pain, difficulty with active abduction and external rotation, pain at night, crepitus may be felt with lifting arm beyond 60° in impingement syndrome Rotator cuff tears Pain and inability to actively abduct the arm, passive abduction is preserved Subacromial bursitis or inflammatory synovitis Features resemble rotator cuff tendinopathy, may be seen with rheumatoid arthritis, polymyalgia rheumatica, or crystal-induced arthritis Adhesive capsulitis (frozen shoulder) Pain, stiffness, and marked loss of shoulder motion; risk factors include diabetes mellitus and prolonged immobilization Bicipital tendinitis Pain and tenderness anteriorly within the bicipital groove Osteoarthritis Associated with damage to the rotator cuff, rheumatoid arthritis, or chondrocalcinosis Myofascial pain Diffuse soft tissue tenderness in the shoulder region and over the chest wall