Shoulder Evaluation 2

Question 1

Biceps tendon pathology:

presentation

Answer 1

• pain in anterior shoulder
• ttp over biceps tendon
• clicking/popping in anterior shoulder
• Popeye deformity (Tendon retraction)

Question 2

Biceps tendon pathology:

treatment

Answer 2

• PT
• NSAIDs, injections
• surgery

Question 3

Biceps tendon pathology:

Special tests

Answer 3

• Active compression test
• Bicipital load
• Speeds test
• Yergason’s test

**none of these exhibit good diagnostic accuracy

Question 4

Crank test:

procedure

Answer 4

supine, shoulder flexed to 110˚

apply long axis pressure simultaneously with ER/IR

Question 5

Crank test: interpretation

symptom reproduction and crepitus are positive tests for

Answer 5

labral derangement or other intra-articular pathology

Question 6

Clunk test: procedure

Answer 6

With axial loading, glide the humerus A/P

Question 7

Clunk test: symptom reproduction and crepitus are positive tests for

Answer 7

labral derangement or other intra-articular pathology

Question 8

What is a SLAP lesion?

Answer 8

superior labral detachment from anterior to posterior

Question 9

SLAP lesions: this tendon is often involved

Answer 9

LHB

Question 10

SLAP lesions: often a tear between (clock)

Answer 10

10-2 o’clock

Question 11

SLAP lesions: A tear between 10-2 o’clock significantly increases the strain on

Answer 11

anterior band of the IGHL

Question 12

SLAP lesions: thought to occur by this mechanism

Answer 12

“peel back mechanism”

maximal shoulder ER thought to peel back the posterior labrum

Question 13

SLAP lesions: most sensitive and specific tests for diagnosis

Answer 13

• MRI arthrogram

- contrast MRI

Question 14

How many types of SLAP tears?

Answer 14

4

Question 15

SLAP lesions: Type 1 characteristics

Answer 15

• isolated fraying of the labrum
• often degenerative in nature
• not concerning to physicians

Question 16

SLAP lesions: Type II

characteristics

Answer 16

• detachment of superior labrum and LHB from the glenoid
• instability in the biceps-labral anchor
• often require surgery

Question 17

SLAP lesions: Type III

characteristics

Answer 17

• bucket-handle tear

- biceps anchor still attached

Question 18

SLAP lesions: Type IV

characteristics

Answer 18

bucket handle tear + bicep anchor detachment

Question 19

SLAP lesions: most common type

Answer 19

Type II

Question 20

Bankart lesions are found in (%) of shoulder dislocations

Answer 20

85%

Question 21

Bankart lesion: occurs where on the clock?

Answer 21

2-6 o’clock on the R shoulder

6-10 o’clock on the L shoulder

Question 22

These lesions commonly occur with Bankart lesions

Answer 22

Hill Sachs

Question 23

Hill Sachs lesion is a compression fx of this aspect of the humeral head

Answer 23

posterolateral

Question 24

Hill Sachs lesion: results from impact on the ___rim of the glenoid during anterior shoulder dislocation

Answer 24

anterior/inferior

Question 25

Hill Sachs lesion: best viewed radiographically with this view

Answer 25

internal rotation or Stryker notch view

Question 26

A reverse Hill Sachs is a compression fx of the ____ humeral head from a posterior dislocation

Answer 26

anterior/medial