My patient has had problems with shoulder pain. He had an acromioplasty performed and continues to complain of marked pain and interference with activities of daily living. On examination, he has mild deficits of shoulder motion and some inconstant crepitation during active range of motion on both sides. However, these findings are also present on his uninjured side. His strength may be a little less about that the injured shoulder. It appears, however, that the patient's pain interferes with his ability to demonstrate full strength. In the Fourth Edition, I would consider rating him using Table 19, Impairment from Joint Crepitation (4th ed, 59) or by the section “Other Musculoskeletal System Defects” where it states
I do not find these approaches in the Fifth Edition, how should I rate him?
The process of assessing motion impairment is similar...