Shoulder and Elbow Problems

Question 1

Which shoulder/elbow injuries are common in teenagers?

Answer 1

Fractures

Instability

Question 2

Which shoulder/elbow injuries are common around age 30-40s?

Answer 2

Rotator Cuff

Capsulitis

Question 3

Which shoulder/elbow injuries are common in 50s and 60s?

Answer 3

Impingement

Acromioclavicular joint

Question 4

Which shoulder/elbow injuries are common in 70s?

Answer 4

Degenerative rotator cuff and joints

Question 5

Cause of upper limb fractures in the young

Answer 5

High enery impact

Question 6

Causes of upper limb fractures in elderly

Answer 6

Osteoporotic injury

Question 7

What is the incidence of the 3 types of shoulder dislocation>

Answer 7

Anterior - 90%
Posterior - 9%
Inferior - 1%

Question 8

What can cause posterior shoulder dislocation?

Answer 8

Electrocution

Seizures

Question 9

What is a common risk to those who have dislocated their shoulder under 20 years of age?

Answer 9

Recurrent instability

Question 10

What is a bankart tear/lesion and what risk does it have?

Answer 10

Tear in the labrum

Increases risk of further dislocation in younger patients

Question 11

Treatment for shoulder dislocation

Answer 11

Manipulation
Immobilisation
Physiotherapy
Surgery

Question 12

A painful arc on abduction of the shoulder suggests which shoulder pathology?

Answer 12

Subacromial impingement

Question 13

According to Bigliani 1991 subacromial impingement is pain and dysfunction caused by which 2 changes?

Answer 13

Decreased volume in the subacromial space

Increased content

Question 14

What can cause a decrease in volume in the subacromial space?

Answer 14

Extra bone - irritates the tendon –> pain

Question 15

What can lead to an increase of content in the subacromial space resulting in a painful arc?

Answer 15

Swollen bursa

Question 16

What is the treatment for subacromial impingement?

Answer 16

Steroid injection
Physiotherapy - rehab of rotator cuff
Arthroscopic subacromial decompression

Question 17

Frozen shoulder is a condition also known as…?

Answer 17

Adhesive Capsulitis

Question 18

Signs and symptoms of frozen shoulder

Answer 18

Pain - constant, affects sleep
Can bend to 90 degrees passively
External rotation less than 50% of normal unaffected side

Question 19

Name 3 differentials for shoulder pain

Answer 19

Infection
Calcific tendonitis
Frozen shoulder

Question 20

Treatment for early presentation of frozen shoulder

Answer 20

Hydrodilatation
Saline
Steroid injection

Question 21

Further management of frozen shoulder- late presentation

Answer 21

Surgery
Physio
Steroid injection

Question 22

Acute treatment for rotator cuff injury

Answer 22

Surgery

Question 23

Treatment for chronic degenerative rotator cuff injury

Answer 23

Surgery if symptomatic

Question 24

What type of surgery is used for treating rotator cuff injury?

Answer 24

Superior Capsular Reconstruction

Question 25

How is the capsule reconstructed in a superior capsular reconstruction surgery?

Answer 25

Cadaveric skin graft on glenoid and humeral head

Question 26

Which tendon is irreparable in surgery for rotator cuff injury?

Answer 26

Supraspinatus tendon

Question 27

3 causes of shoulder arthritis

Answer 27

Osteoarthritis Inflammatory arthritis Post-trauma arthritis

Question 28

Treatment of shoulder arthritis

Answer 28

Humeral head replaced

Question 29

What is paramount before initiating treatment (humeral head replacement) for shoulder arthritis?

Answer 29

Integrity of the rotator cuff - will wear out replacement joint if unstable

Question 30

How may surgery to treat arthritis in the shoulder be reversed?

Answer 30

Shoulder replacement - maximise deltoid function

Question 31

Which elbow injuries are common in younger patients?

Answer 31

Fractures and dislocations

Question 32

Which elbow injuries are common in middle aged patients?

Answer 32

Tendinopathies

Question 33

What is the main cause of elbow injuries in elderly patients?

Answer 33

Degenerative

Question 34

Sign of cubital tunnel syndrome

Answer 34

Pain and paraesthesia in ulnar region

Question 35

Management of cubital tunnel syndrome

Answer 35

Decompress ulnar nerve

Question 36

Why would occupation be an important part of history in cubital tunnel syndrome?

Answer 36

Positional ulnar nerve compression- constantly flexed elbow?

Question 37

Site of pain in golfers elbow

Answer 37

Pain on inside of forearm

Question 38

Site of pain - tennis elbow

Answer 38

Pain on outside of forearm

Question 39

Management of golfers/tennis elbow

Answer 39

Steroid injection | Avoid surgery

Question 40

What type of blood is steroid injection derived from?

Answer 40

Horse blood

Question 41

Where is steroid injection directed?

Answer 41

Site around painful tendon

Question 42

Role of platelets and GF in management of golfers/tennis elbow?

Answer 42

Healing response in deep part of degenerative tendon | First line treatment

Question 43

Subscapularis inserts into...

Answer 43

Lesser tuberosity of humerus

Question 44

Name given to socket

Answer 44

Glenoid

Question 45

Coracoid process - which muscles attach

Answer 45

Coracobrachialis

Question 46

What articulates at the capitellum?

Answer 46

Radius with humerus

Question 47

What articulates at trochlea?

Answer 47

Ulna

Question 48

3 pathologies of rotator cuff

Answer 48

Tendinitis Bursitis Rotator Cuff tear - supraspinatus most common and in tendinitis also

Question 49

Painful arc typical to supraspinatus tendinitis

Answer 49

60 to 120 degrees