Shoulder and elbow problems Flashcards
Describe the shoulder joint and its traumatic dislocation
Shoulder joint is the most mobile joint in the body. Stability is sacrificed for mobility. Common dislocation is anterior (90%), followed by posterior (9%), inferior (1%). Usually results from trauma.
What is the management for shoulder dislocations?
Manipulation (surgical procedure to relieve stiffness and poor ROM). Immobilisation. Physiotherapy. Surgery.
What is (subacromial) impingement syndrome?
Pain and dysfunction resulting from any pathology which decreases the volume of the subacromial space or increases the size of the contents.
How would you manage subacromial impingement?
Subacromial steroid injection. Physiotherapy. Arthroscopic subacromial decompression.
What is Frozen shoulder?
AKA adhesive capsulitis. A well-defined disorder characterised by progressive pain and then stiffness of the shoulder. Has no clear single cause and usually resolves spontaneously over about 18 months. It may occur after trauma and is more common with diabetes mellitus.
How would you treat frozen shoulder?
Hydrodilatation. Early presentation – inject steroid. Later – surgery
What is a rotator cuff tear?
An injury of one or more of thetendons/musclesof therotator cuffof theshoulder. Symptoms may includeshoulder pain, which is often worse with movement, or weakness. Can be traumatic or degenerative in nature (causes).
How would you treat a rotator cuff tear?
Acute rotator cuff tears = early surgery
Chronic degenerative tears = surgery if symptomatic.
Superior capsular reconstruction (massive irreparable tears)
Describe osteoarthritis of the shoulder
A gradual wearing of the articular cartilage that leads to pain and stiffness. As the joint surface degenerates, the subchondral bone remodels, losing its sphericity and congruity. The joint capsule also becomes thickened, leading to further loss ofshoulderrotation.
OA, inflammatory arthritis, post-traumatic arthritis. Rotator cuff integrity is paramount.
How would you treat shoulder OA?
Complex reconstruction – custom made implants, based of 3D reconstruction from CT, specifically made for patients.
What do shoulder fractures usually result from
Usually Young high energy injuries. Can also be Elderly osteoporotic injuries.
Describe tennis elbow
A condition that causes pain around the outside of the elbow. Its clinically known as lateral epicondylitis. It often occurs after strenuous overuse of muscles and tendons of the forearm (extensors – attach to lateral epicondyle).
Describe golfer’s elbow
A condition that causes pain where the tendons of your forearm muscles attach to the inside of elbow (flexors). Medial epicondylitis. Pain might spread to forearm and wrist. Similar to tennis elbow, which occurs on outside of elbow.
How would you treat tennis and golfer’s elbow?
Rest and massage. Analgesic (NSAIDS esp.). Local corticosteroid injection. Surgery.
What is olecranon bursitis?
A condition characterised by swelling, redness and pain at the tip of the elbow. Underlying mechanism is inflammation of the fluid filled sac between olecranon and skin.
