Upper Limb Problems Flashcards
How do patients often present to GP with shoulder problems
Pain
Stiffness
Deformity
Loss of function
List some common shoulder problems
Rotator cuff problems - especially supraspinatus
Sub-acromial bursitis
Acromioclavicular disease - trauma in young, OA in elderly
How can a GP manage shoulder pain
Explanation Mobilise - physio NSAIDs - short term Local injections Time - often take ages to heal Referral - rare
List some less common shoulder problems
Frozen shoulder
OA or RA of shoulder
Recurrent dislocation
What is a frozen shoulder
Impingement disease
Affects middle aged
Common in diabetics
Which pathologies cause painful external rotation
Pathology of the glenohumeral joint
Arthritis
Frozen shoulder
What are the most common symptoms of upper limb arthritis
Pain Swelling Stiffness Deformity Loss of function
What are the causes of upper limb arthritis
Degeneration - OA
Inflammation - RA etc
Post-traumatic
Septic - infection in joint
List the treatment options for upper arm arthritis
Nothing! Rest or splints Analgesia Steroid injections - temporary solution Replace Fuse - good in wrist Excise
Describe arthritis in the sternoclavicular joint
Rare
Get swelling & pain over joint
Treat with physio, injection but very rarely surgery
Describe arthritis in the acromioclavicular joint
Very common
Often occurs with impingement and trauma
Treat with injection and/or excision
What can cause arthritis in the glenohumeral joint
Cuff tear
Instability
Previous surgery
Idiopathic
What are the symptoms of arthritis of the glenohumeral joint
Pain
Crepitus
Loss of movement - especially external rotation
List some potential complications of shoulder replacements
Infection Instability Stiffness Nerve damage Loosening
Describe rotator cuff arthropathy
Rotator cuff should centre humeral head on glenoid but if torn the deltoid pulls the head upwards
Puts abnormal force on glenoid which leads to wear and OA
