2: Joint Disorders Of The Shoulder Flashcards
How may impingement syndrome present
pain on abduction of the shoulder
What is a sign of impingement syndrome
‘painful arc’: pain on abduction of the arm from 60-120’
Which is the most common rotator cuff to tear
supraspinatus
How will supraspinatus tear present
pain over the deltoid region particularly on over-head activities
How will adhesive capsulitis present
restricted range of movement in all directions
which movement is particularly worse in adhesive capsulitis
external rotation
how will glenohumeral OA present
pain on activity, waking pain at night
how will acromioclavicular OA present
pain on raising arms above the head
how will biceps tendinopathy present
anterior shoulder pain worse on bicep contraction
what is the most common cause of shoulder problems
rotator cuff injury
explain the ‘spectrum of rotator cuff injury’
- Impingement syndrome
- Calcific tendonitis
- Rotator cuff tear
- Rotator cuff arthropathy
how can rotator cuff tears be classified
Partial thickness or full thickness
what is a full-thickness tear
When the rotator cuff is separated from the humerus
what is a partial thickness tear
Tear within the rotator cuff, remains attached to the humerus
which rotator cuff is most commonly affected
Supraspinatus
what causes an acute rotator cuff tear
Violent stretching of tendons
what causes a chronic rotator cuff tear
‘Wear and tear’ of the rotator cuffs over time
explain the pathophysiology of chronic rotator cuff tears
On ageing, blood supply to the rotator cuff muscle decreases. This means they are less adapted to heal from injury leading to progressive damage.
in which population are chronic rotator cuff tears more common
Elderly.
what causes impingement
When there is a bony spur from the acromion than impinges the rotator cuff tendons during abduction
How will an acute rotator cuff tear present
- Acute + intense pain over the deltoid region.
- Night pain
- Pain is exacerbated by overhead movements
- Shoulder weakness (abduction and rotation)
How may a chronic rotator cuff tear present
Pain may be absent or only when lifting shoulder overhead
When should a rotator cuff injury be suspected in >50y
Pain or Loss Of Function, following low energy trauma
When should a rotator cuff injury be suspected in <50y
Pain following high-energy trauma