must evaluate the patient’s history and

perform a thorough physical examination to establish a

strong correlation in the features of each pathologic
process. Our confi dence rises when the patient’s history
of the complaint is consistent with the majority of the
physical fi ndings. This confi dence rises even more when
radiographic and laboratory studies are also consistent
with the initial diagnosis. When each of these features of
the patient evaluation point to the same diagnosis, our
certainty of the correct diagnosis becomes assured. It is
obviously much more disconcerting when a patient’s
history suggests impingement syndrome, the physical
examination is more consistent with instability