The purpose of the study is to determine whether the introduction of early ultrasonography screening will change the diagnostic spectrum of soft tissue shoulder injuries in patients aged forty years or more. We also want to study whether certain physical tests will be able to predict or rule out full-thickness tears of the rotator cuff (shoulder tendons) in the acute phase. Another purpose is to explore the course of soft tissue shoulder injuries over a year, as well as to compare the results to studies on the prevalence of rotator cuff full-thickness tears.

Inclusion Criteria, all of the following:

• patient at Section for Orthopaedic Emergency, Oslo University Hospital
• living in the municipality of Oslo
• acute injury
• sudden onset of symptoms
• International Classification of Diseases (ICD) -10 S4-diagnosis (except injuries of middle and distal third of humerus and related soft tissue)
• no sign of acute injury on radiographs in two views, or successfully reduced dislocation without fracture
• turns up for follow-up appointment within 21 days of injury

Exclusion Criteria:

• patients that are incapable of giving and or receiving adequate information, or that cannot undergo a normal clinical investigation, due to for example language problems, level of consciousness, drugs, mental or emotional status or other
• patients that have undergone shoulder surgery during the last 6 months
• injury of both shoulders
• patients with neck-/shoulder problems or generalised muscle pain during the last three months before the injury
• other serious disease such as cancer, rheumatic disorders, haematological, neurological, endocrinological or gastrointestinal disease that according to the doctor's best clinical judgement makes participation or follow-up difficult
• does not want to participate

All patients living in the municipality of Oslo that visit Section for Orthopaedic Emergency (Oslo skadelegevakt), Oslo University Hospital with an acute shoulder injury.