Shoulder problems Flashcards
(31 cards)
What is frozen shoulder also known as?
adhesive capsulitis
In what group of ppl is frozen shoulder more common?
middle age female
What condition is frozen shoulder associated w?
DM
What can be found on examination in a patient with frozen shoulder?
Active and passive block to all movements
External rotation is usually reduced compared to other shoulder
What is the management of frozen shoulder?
- NSAIDs
- Physio
- Oral intra-articular steroids
- Surgery
What causes impingement syndrome?
tendonitis of RC muscles as they pass through subacromial space
What muscle is usually affected in impingement syndrome?
supraspinatus
What are the symptoms of impingement syndrome?
insidious onset of pain
exacerbated by overhead activities and lifting objects away from the body
What can be found on examination in a patient with impingement syndrome?
Tenderness over the greater tuberosity
Painful arc (60-120)
Positive Neer’s and Hawkin’s sign
What is the treatment for impingement syndrome?
steroid injections
surgery - remove impinging structures or widen subacromial space
What are the types of shoulder dislocation? which one is the most common?
- Glenohumeral - most common
- Acromioclavicular
- Sternoclavicular
What is the most common type of GH dislocation?
anterior
What is the mechanism of injury in anterior shoulder dislocations
anteriorly directed force on arm when shoulder is abducted and externally rotated
What is the management of shoulder dislocations?
- REDUCTION
- Check neurovascular status pre and post reduction
- XR post reduction to ensure no fracture
What is a Bankart lesion?
avulsion of the anterior glenoid labrum due to anterior shoulder dislocation
What is a Hill-Sachs lesion?What causes them?
cortical depression in the posterolateral head of the humerus
secondary to recurrent anterior shoulder dislocations
What may be found on examination of a patient with ACJ arthritis ?
tenderness over the ACJ
pain on abduction (160-180)
positive scarf test
How would you distinguish between a frozen shoulder and osteoarthritis?
Osteoarthritis - usually older patients, may have audible crepitus
XR only true way to distinguish
What are the muscles of the rotator cuff? what are their actions?
Supraspinatus - abduction and external rotation
Infraspinatus - external rotation
Teres minor - external rotation
Subscapularis - internal rotation
What is the main function of the rotator cuff?
stabilise the shoulder
What are the different mechanisms that can lead to rotator cuff tear?
- chronic degenerative (older pts) - stress from repeated movements
- chronic impingement
- acute avulsion (younger following falls)
- iatrogenic
Where do the majority of rotator cuff tears occur?
supraspinatus, infraspinatus and teres minor (SIT)
What are the symptoms in rotator cuff tears
Pain
weakness
Explain how you test the rotator cuff muscles
Supraspinatus - pain/weakness in Jobe position
Infraspinatus - LAG sign
Subscapularis - lift off test or belly press
There is loss of active ROM and intact passive ROM
