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Posterior shoulder instability (PSI) is a condition increasingly diagnosed in young, active patients. Because of the need for its accurate diagnosis, it is important to understand the symptoms of PSI and the types of sports and other activities that raise the risk of its occurrence. Physical examination plays a key role in the diagnosis of PSI, and several specific, provocative tests can be performed to identify its presence. Patients in whom the nonsurgical management of PSI fails may be candidates for surgical intervention, with arthroscopic techniques providing good results when used under the appropriate indications.

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