Medical Screening for Shoulder pain Flashcards
Myelopathy questions
Cluster- age over 45. difficulty walking, +babinski, +hoffman, + inverted supinator sign. N/T in both arms and legs and clumsiness in hands and feet
MI vs angina
MI- cardiac event warranting immediate EMS
Angina- symptomatic HTN. Can be controlled with medication
CV pain men vs women
Men- more likely to attribute to muscle pain or indigestion
Women- more likely to report epigastric symptoms and jaw, neck and arm and shoulder pain
PE common symptoms
-Difficulty breathing at rest or with exertion
-tachypnea- can’t catch breath
-chest pain
-tachycardia
-calf or thigh swelling
-cough
-hemoptysis- urgent sign
PE screening tool
Modified wells
x>4= more likely
Revised Geneva score
x>5
Conditions of the gallbladder- and shoulder pain
R shoulder pain
+murphy sign- pain to palpation R upper quadrant
- recent vomiting or nausea
-symptoms 30 mins after eating fatty foods
Conditions of the spleen
Spleen rupture
-pain in L shoulder
-severe abdominal pain with palpation of LUQ
-If pain in L shoulder with palpation of L UQ= Kehr’s sign
HR- x>100
-BP x<90/60
Tumors and shoulder pain
Breast cancer
Pancoast tumor
Risk factors of breast cancer and malignancy where
Age over 50, history of cancer, can spread to long bones
Pancoast Tumor
Tumor of superior sulcus of lung
-Hx of smoking, age greater than 50,
-Pain in shoulder and arm (C8-T1 distribution)
Horner’s syndrome-
Horner’s syndrome
Decreased pupil size
Drooping eyelid
Decreased sweating on the side of the face
Screening for proximal humerus fx
COmmon after fall
Females>males
Severe shoulder pain’
OP
If N/T or absent pulses need to be seen immediately
Lifestyle factors affecting prognosis
Lifestyle medicine assessment score of x<20.
DOmain score of x<7 (recovery nutrition, substance abuse and movement)
Not well rested
Eating mostly processed food
Smoker/ substance abuse
No physical activity/exercise
