Shoulder conditions

Question 1

What kind of joint is the shoulder?

Answer 1

Synovial

Question 2

What forms the shoulder joint?

Answer 2

Glenoid fossa of the scapula

Humeral head

Question 3

What 4 muscles make up the rotator cuff?

Answer 3

Supraspinatus
Infraspinatus
Subscapularis
Teres minor

Question 4

How is supraspinatus tested?

Answer 4

Hands semi-prone and push down

Question 5

How is infraspinatus tested?

Answer 5

Trying to push hands together

Question 6

How is subscapularis tested?

Answer 6

Hand at small of back and push

Question 7

How is teres minor tested?

Answer 7

Not tested clinically

Question 8

What do the rotator cuff muscles do?

Answer 8

Pull the humeral head into the glenoid to provide a fulcrum for stability

Question 9

What age is most likely to be affected by shoulder instability?

Answer 9

Young adults

Question 10

What age does rotator cuff tears affect?

Answer 10

Middle aged

Question 11

What is impingement syndrome?

Answer 11

Tendons of rotator cuff are compressed in the tight subacromial space

Question 12

Between what degrees of abduction can the painful arc of impingement syndrome be seen?

Answer 12

60 and 120

Question 13

What are possible causes of impingement syndrome?

Answer 13

Tendonitis
Subacromial bursitis
Acromioclavicular OA with inferior osteophytes
Rotator cuff tear

Question 14

Where does the pain from impingement syndrome radiate to?

Answer 14

Deltoid and upper arm

Question 15

What clinical test is for impingement?

Answer 15

Hawkins-Kennedy

Question 16

What is the treatment for impingement syndrome?

Answer 16

NSAIDs, analgesics, subacromial injection of steroids ( up to 3)

Question 17

What is a “classic history” of a rotator cuff tear?

Answer 17

Sudden jerk in a pt >40 with subsequent pain and weakness

Question 18

Which muscle do rotator cuff tears usually affect?

Answer 18

Supraspinatous

Question 19

Which imaging technique can confirm tears?

Answer 19

USS

MRI

Question 20

What are the options for repair?

Answer 20

Physio to strengthen remaining muscles

Open or arthroscopic rotator cuff repair

Question 21

What are the negatives to surgically treating rotator cuff repairs?

Answer 21

Many tendons are diseased and so repair can fail.

Very large tears may be irreparable

Question 22

What is frozen shoulder also known as?

Answer 22

Adhesive capsulitis

Question 23

What does frozen shoulder present as?

Answer 23

Pain which subsides after 2-9 months

Increasing stiffness for 12/12 which then thaws

Question 24

What is the principal clinical sign of a frozen shoulder?

Answer 24

Loss of external rotation

Question 25

Which condition pre-disposes to adhesive capsulitis?

Answer 25

Diabetes

Question 26

What is the treatment for adhesive capsulitis?

Answer 26

Physiotherapy and analgesics. | Intra-articular injections.

Question 27

What is calcific tendonitis?

Answer 27

Calcium deposits in the supraspinatous tendon, just proximal to greater tuberosity.

Question 28

What is the onset of action of calcific tendonitis?

Answer 28

Acute!

Question 29

What relief can be provided for calcific tendonitis?

Answer 29

Subacromial steroid and local anaesthetic injection

Question 30

What are the two types of instability?

Answer 30

Traumatic | Atraumatic

Question 31

What is the repair called to stabilise recurrent dislocations?

Answer 31

Bankart repairs

Question 32

Which conditions can pre-dispose to atraumatic instability?

Answer 32

Marfans | Ehlers-Danlos

Question 33

Pain in what other areas of the body can cause shoulder pain?

Answer 33

Neck Angina Diaphragmatic irritation

Question 34

Where is the long head of the biceps?

Answer 34

At the labrum/glenoid

Question 35

What does Bigliani grading show?

Answer 35

Increasing angles of acromion. Higher grade is more likely to have an impingement.

Question 36

What are Bankart lesions?

Answer 36

??

Question 37

What are Hill Sachs lesions?

Answer 37

??

Question 38

What nerve is involved in carpal tunnel syndrome?

Answer 38

median

Question 39

What nerve is involved in cubital tunnel syndrome?

Answer 39

Ulnar nerve

Question 40

What are the more common shoulder issues?

Answer 40

Supraspinatous tendonitis Sub-acromial bursitis Arcomioclavicular disease