出處:e-medicine
http://www.emedicine.com/pmr/topic132.htm
主作者: Robert Gould, DO , Staff Physiatrist, SpineONE, Orthopaedics Northeast
次作者:Susan S Barnes, DO , Assistant Professor, Department of Physical Medicine and Rehabilitation, Michigan State University
August 5, 2005

"Shoulder and Hemiplegia"

Cause:
Glenohumeral subluxation

"Controversy exists as to an association between shoulder subluxation and pain. Subluxation has been a commonly sited cause of shoulder pain and disability, with Yu et al reporting that longitudinal data suggests a correlation between early subluxation and shoulder pain. However, Bohannon et al have found no significant correlation between the presence of subluxation and the occurrence of pain, while Wanklyn et al have found no association between the severity of subluxation and the degree of pain. Numerous cases of subluxation without pain have been documented, as well as cases of a painful shoulder without subluxation."

輕微的脫臼(脫位)可能跟疼痛沒有關係...並不是所有的脫臼就都會痛的死去活來...

"# Bohannon et al found that performing shoulder palpation to help diagnose subluxation can be reliably graded, with good interrater reliability and good correlation with more precise radiographic measurements.
# Other authors believe that there are no precise clinical means to measure the degree of subluxation, and if one could be devised, then the benefit of treatment would be validated.
#Several radiographic methods that give a reliable measure of subluxation have been proposed, but some require specialized equipment that is not widely available."

除了Bohannon et al之外,其他的作者都認為沒有可用於診斷輕微脫臼上的可靠臨床檢查,甚至回診的時候可能也無以判斷治療的療效,而且在放射學診斷上有X光設備跟技術上的限制...