shoulder pain

[monak84]

Hi,
I would like some advice about this patient.
Female patient,35yrs of age,was working as a labourer but has quit her job 4yrs ago.Does only housework presently.She has been complaining about pain over the right shoulder radiating to her elbow.No history of fall or trauma.ROM is restricted due to pain.
Tenderness over ant.aspect of shoulder.She has got severe trapezius spasm,but has been relieved to quite an extent aftr MFR(myofascial release) and SSF(strong surged faradic current).

Cervical n shoulder xrays are normal.

She took ultrasound for around 5days bt no relief.

The MRI report -supraspinatus n bicipital tendonitis.

i wanted to know,how would u diagnose the condition without an MRI n wat treatment would u suggest.

thank u.

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