Rule out major structural or other pathologies as the cause of the symptoms.

Risk factors for serious pathologies (also known as red flags -see next step in algorithm) identified during the history and examination warrants further investigation and referral to the appropriate healthcare provider. Once pathology has been ruled out, the patient should be treated according to the shoulder pain care pathway. 

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No

No

Yes

Are symptoms ≤3 months?

Yes

Yes

No

Yes

Yes

No

No

Discharge

Are symptoms >3 months?

Yes

Discharge

Yes

No