Common Shoulder Problems Flashcards Preview

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Flashcards in Common Shoulder Problems Deck (23)
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1
Q

Which type of shoulder dislocation is easily seen?

A

Traumatic anterior dislocation

2
Q

Why is posterior dislocation often missed?

A

It is rare, not easy to see on an Xray.

3
Q

How do patients with posterior dislocation of the shoulder present?

A

With shoulder pain, usually holding arm in internal rotation. Unable to externally rotate.

4
Q

What causes posterior dislocation of the shoulder?

A

Caused by the surrounding muscles such as the rotator cuff muscles contracting so hard that they pull the structures off the joint and dislocate it e.g. electric shock or seizure.

5
Q

What is a comminuted fracture?

A

A comminuted fracture is a break or splinter of the bone into more than two fragments. Since considerable force and energy is required to fragment bone, fractures of this degree occur after high-impact trauma such as in vehicular accidents.

6
Q

What happens in a displaced fracture?

A

Not just a crack in the bone, joint becomes unstable since the parts have moved apart and are no longer correctly aligned.

7
Q

What is the treatment for a clavicular fracture?

A

Treatment varies, sometimes they can be left to heal, other times they need fixing. Clinical trials are required to access risk and benefit.

8
Q

What is calcific tendinitis?

A

A degenerative condition in which there is a calcium hydroxyapatite deposit (CHD) in tendons (commonly in rotator cuff tendons). They can cause sudden attacks of painful inflammation due to a build up of pressure and chemical irritation.

9
Q

What happens if the CHD in the shoulder is large?

A

Subacromial impingement. It can also burst leading to acute calcific tendinitis. Gives extreme pain for 1-2 weeks and then usually resolves on its own.

10
Q

What is ‘popeye muscle’?

A

Long head of the biceps ruptures. Lose partial attachment for the muscle but it is still attached at the short tendon of biceps and so can still function.

11
Q

What causes the long head of the biceps to rupture?

A

Often occurs in old age due to overuse, wearing down or degeneration of the tendon. Can also occur from sudden contraction of the biceps with resistance to flexion e.g. lifting something heavy.

12
Q

What causes impingement in the sub-acromial bursa?

A

Inflammation within the bursa, inflamed or large tendon or a more curved acromion.

13
Q

What would an examination of impingement in the sub-acromial bursa show?

A

No pain in full abduction of the arm (structures move beneath acromion. Positive Hawkins test. Ultrasound scan might show bursitis, tendinopathy or dynamic impingement.

14
Q

How do you treat sub-acromial impingement?

A

Steroids and physic or surgical decompression

15
Q

What is a rotator cuff tear?

A

A tear in one or more of the tendons of the rotator cuff muscles.

16
Q

What is rotator cuff arthropathy?

A

Rotator cuff tears may lead to the humeral head rubbing against the bones around it. Common in the elderly. Glenohumeral arthritis.

17
Q

What are the symptoms of acromioclavicular osteoarthritis?

A

Normally asymptomatic. High painful arc, positive scarf test, tender joint. Xray/MRI can confirm diagnosis

18
Q

How is acromioclavicular osteoarthritis treated?

A
  • NSAID’s
  • Injection
  • Excision of the lateral clavicle
19
Q

What are the symptoms of glenohumeral osteoarthritis?

A

Progressive pain and stiffness over years, crepitus.

20
Q

What is the treatment of glenohumeral osteoarthritis?

A

Analgesia and exercises, steroid injections, eventual joint replacement.

21
Q

What is frozen shoulder?

A

Adhesive capsultisis, the shoulder capsule surrounding the GH joint becomes inflamed and stiff reducing the movement and causing chronic pain.

22
Q

What are the symptoms of adhesive capsulitis?

A

Pain - severe, progressive, nocturnal, jerk pain followed by progressive stiffness that usually resolves after 2-3 years.

23
Q

What is the treatment for frozen shoulder?

A

Surgery to cut the adhesions (capsular release), manipulation under anaesthesia.