Introduction In most patients, shoulder pain has a neuromusculoskeletal cause. However, it might conceal other types of disorders, hiding a non‐neuromusculoskeletal condition. The main aim of this scoping review is to map and summarise findings to identify red flags for gastrointestinal and hepatic diseases in the assessment of patients with shoulder pain. Methods Five databases were searched up to 31 May 2021. Additional studies have been identified through grey literature, and the reference lists of the included studies have been screened. Any study design and publication type have been considered to be eligible for inclusion. No time, geographical setting and language restrictions have been applied. Results A total of 157 records have been identified, with 40 studies meeting the inclusion criteria (37 case reports, 2 retrospective studies and 1 systematic review with meta‐analysis). The most prevalent red flags associated with shoulder pain were abdominal pain (14 cases) and abdominal discomfort (3 cases), reported by 47% of patients. As for comorbidities, hepato‐gastric, cardiac, visceral and systemic diseases were the most common ones. Conclusion Abdominal pain, right and left hypochondriac pain, and epigastric pain represent the most prevalent symptoms in patients with an abdominal disease that could mimic a shoulder problem. Clinicians should be encouraged to screen for red flags when assessing patients with shoulder pain.

Shoulder pain (SP) is the third most common musculoskeletal disorder worldwide and its prevalence ranges from 5 to 47%. However, the clinical presentation of signs and symptoms may hide other serious conditions; the so-called Red Flags (RFs). For these reasons, clinicians dealing with neuro-musculoskeletal shoulder disorders should pay particular attention during the medical history and clinical examination screening and identifying signs that may cause probable referred symptoms. Considering the variety of clinical presentations of SP and the importance of the screening for referral, identifying and summarizing the possible gastrointestinal and hepatic diseases among these patients may give a comprehensive overview to the clinicians and consequently may improve the overall management. To the authors knowledge, there are no published studies on the topic and, in this context, a scoping review is strongly required and corresponded to the objectives of this project.