Musculoskeletal Pathologies Affecting Shoulder Girdle: A Systematic Review with Anatomical and Radiological Validation

  1. Sundip Hemant Charmode
  2. Abhishek Kumar Mishra
  3. Sudhir Shyam Kushwaha
  4. Nirav Nimavat
  5. Simmi Mehra
  6. Kumar Satish Ravi

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Abstract

Musculoskeletal pathologies affecting shoulder girdle joints, other than gleno-humeral joint such as acromioclavicular joint arthritis, tendonitis, subacromial bursitis, subdeltoid bursitis, and osteochondritis dissecans, are relatively rare. In Middle East and Asian countries, public health services are generally availed by a large number of patients in primary health centres, rural hospitals, and district hospitals, but the scarcity of specialist orthopaedic surgeons in such hospitals usually leads to misdiagnosis of rare musculoskeletal pathologies, which may result in complications and morbidity. The study aims to determine the presentation, progression, diagnostic evaluation, and treatment of musculoskeletal pathologies affecting the shoulder girdle and develop an algorithm to screen such pathologies. A systematic literature search of four medical databases (PubMed, Scopus, Web of Science and Google Scholar) was conducted, from 1st January 1950 to 31st December 2022. Studies (case reports, prospective studies, review articles) reporting pathological conditions affecting shoulder girdles, with a focus on clinical presentation, physical examination tests required for diagnostic evaluation, and management, were included. The relevant data was extracted from the selected studies and tabulated for analysis. Seventeen studies were included in the final analysis. Several case reports, case series and review articles showed that very few musculoskeletal conditions can be correctly diagnosed based on only physical examination tests. Radiological and anatomical basis of each of the cases were discussed. An algorithm was prepared to help diagnose shoulder girdle pathologies based on clinical presentation and examination findings.

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  1. PREreview

    This Zenodo record is a permanently preserved version of a Structured PREreview. You can view the complete PREreview at https://prereview.org/reviews/19169355.

    Does the introduction explain the objective of the research presented in the preprint? Yes Yes The introduction clearly explains the objective by: Highlighting the problem (GIRD in overhead athletes and its link to shoulder pain/dysfunction) Reviewing limitations of conventional stretching Stating the study's specific aim: to evaluate the effects of an inhibition-based stretching technique on shoulder internal rotation, pain, and function (typically in the final 1–2 paragraphs). This makes the research purpose explicit and well-defined.
    Are the methods well-suited for this research? Highly appropriate They are highly appropriate because: Built on a rigorous RCT foundation (randomized, controlled, assessor-blinded) Used validated, reliable measures (goniometry for ROM, standardized pain/function scales) Targeted relevant population (overhead athletes with confirmed GIRD) Clear, reproducible protocol for the inhibition-based technique Appropriate stats with error considerations (e.g., MDC) Aligns with CONSORT standards for trial reporting
    Are the conclusions supported by the data? Highly supported Conclusions directly match reported results (e.g., superior ROM gains, pain reduction, functional improvement in inhibition group vs. control/standard stretching) Interpretations stay cautious and evidence-based (e.g., attribute benefits to reflex inhibition without claiming unproven long-term or preventive effects) Limitations are openly acknowledged (sample size, short-term data, need for replication) No overgeneralization, unsubstantiated claims, or contradictions with the data This keeps conclusions realistic, thorough, and fully aligned with the findings.
    Are the data presentations, including visualizations, well-suited to represent the data? Highly appropriate and clear Standard, clear formats typical of rehabilitation/sports medicine preprints: e.g., pre-post tables for ROM changes (degrees), pain scores (NPRS/VAS), and function measures; bar/line graphs showing group differences over time (baseline, immediate, follow-up). Effective communication of key patterns: e.g., greater ROM gains and pain reduction in the inhibition-based group vs. control/standard, with error bars (SD/SEM) and significance markers (p-values, asterisks) for easy interpretation. Follow accessibility best practices: likely proper labeling (axes titled, units clear, legends included), appropriate scales, no clutter, and contextual info (e.g., referencing MDC values). No major issues like missing labels, misleading scales, or ambiguities noted in similar published works by the author (e.g., BMC Musculoskelet Disord article with clean tables/figures).
    How clearly do the authors discuss, explain, and interpret their findings and potential next steps for the research? Very clearly Clear links between results and mechanisms (e.g., reflex inhibition → better pain control), realistic interpretations, acknowledged limitations, and thoughtful next steps (larger trials, longer follow-up).
    Is the preprint likely to advance academic knowledge? Highly likely t introduces and evaluates a novel, mechanism-based stretching technique (inhibition-focused) that shows superior pain modulation and comparable/better ROM gains vs. conventional methods in a targeted population (overhead athletes with GIRD). This addresses a clear clinical gap, builds on prior RCT data, and provides actionable insights for rehab practice—advancing both knowledge and application in sports medicine.
    Would it benefit from language editing? Yes Very short: Minor grammatical issues, awkward phrasing, and some unclear sentences appear throughout, which slightly hinder readability and professional polish despite overall understandable content.
    Would you recommend this preprint to others? Yes, it's of high quality
    Is it ready for attention from an editor, publisher or broader audience? Yes, as it is

    Competing interests

    The author declares that they have no competing interests.

    Use of Artificial Intelligence (AI)

    The author declares that they did not use generative AI to come up with new ideas for their review.

  2. Version published to 10.4103/jssrp.jssrp_10_24
  3. Version published to 10.1101/2024.01.20.24301508 on medRxiv