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Y1 TP2 Musculoskeletal System > 7. Shoulder > Flashcards

7. Shoulder Flashcards

1
Q

Clavicle (collar bone)

A

Superior surface is smooth
• Acts like a strut – holds out shoulder and scapula joints
• S-shaped curve – provides strength

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2
Q

Sternoclavicular joint:

A

—> synovial joint between sternim and clavicle
• Synovial joint
• Allows movement
• Articular disc – acts as a shock absorber

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3
Q

Clavicle dislocation

A

Dislocations (when clavicle pops out of joint) are rare due to ligaments

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4
Q

Inferior surface of clavicle

A

Inferior surface is rough
• Due to the attatchments – of costoclavicular ligaments, subclavius muscle attatch at, attachment of coracoclavicular ligmaent

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5
Q

Acromoclavicular joint

A

–> between acromion and clavicle
• plane type of synovial joint
• Supported by acromoclavicular and coracoclavicular ligaments
• Note Subclavian groove = site of attachment of subclavius muscle
• Suspend the upper limb from clavicle – scapula hangs from the clavicle

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6
Q

Scapula (shoulder blade)

A
  • Triangular & flat

* Overlies ribs – posterior ribs 2nd - 7th rib

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7
Q

Scapula Posterior surface

A
  • spine of scapula
  • supraspinous fossa (above spine)
  • infraspinous fossa (below spine)
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8
Q

Borders of scapula

A

• Medial border – by thoracic spine

Superior border: suprasternal notch

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9
Q

Angles of scapula

A

• Superior, inferior and lateral angles
• Lateral angle = head of scapula and small and shallow glenoid cavity
• The lateral angle has head of scapula
– Small & shallow glenoid cavity

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10
Q

Spine of scapula

A

• Spine continues laterally as acromion = point of shoulder

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11
Q

Anterior concave surface of scapula

A
  • Subscapular fossa
  • Coracoid process – like a bent finger pointing to shoulder
    • Concave surface as it contour the ribs
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12
Q

Proxiaml humerus

Basic structure

A 
Spherical head and 2 necks 
• Greater tubercle laterally 
• Lesser tubercle anteriorly 
• Intertubercular (bicipital) groove – contains tendon of long head of biceps 
	• Between greater and lesser tubercle
  • Laterally Deltoid tuberosity – site of attatchment of deltoid muscle
  • Posteriorly oblique radial (spiral) groove – radial nerve and profunda brachii artery
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13
Q

Proximal humerus - • Anatomical neck

A

– proximal to tubercles
– joint capsule
Between head and tubercles

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14
Q

Proximal humerus - • surgical neck

A

– distal to tubercles

– common site of fractures

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15
Q

Glenohumeral joint

A

• Synovial / Ball and socket = between humerus and scapula

  • Cavity accepts approx. 1/3 of humeral head (not as deep of a socket)
  • Deepened by fibrocatilaginous labrum - rotator cuff
  • Joint capsule (lined by synovium) – margin of glenoid cavity (attach medial) & anatomical neck (attach lateral)
  • Inferior part of capsule = weakest area
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16
Q

Glenohumeral joint – openings

A

• 2 openings
– between tubercles of humerus
• Tendon of long heads of biceps brachii
– anteriorly – communication with subscapularis bursa

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17
Q

• Glenohumeral Joint ligaments

A

– 3 fibrous bands reinforce anterior capsule (reinforce joint)
• 3 bands = superior, middle and inferior

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18
Q

• Coracohumeral ligament

A
  • From greater tubercle to coracoid process

* Superir to joint

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19
Q

• Coraco-acromial arch

A

– 2 bones and Coraco-acromial ligament (corcoid process, acromion and corcoid ligament)
– strong
– prevents superior displacement of head

Tendon, bursa arch

• Supraspinatus passes under arch
• Subacromial bursa facilitates movement of
– Supraspinatus tendon
- deltoid

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20
Q

7 Movements at glenohumeral joint

A
  • Flexion
    • Extension
    • Abbduction
    • Adduction
    • Medial rpotation
    • Lateral rotation
    • Circumduction
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21
Q

Shoulder abduction

A

When abbducted to 90 degrees, when abducted iwhtout rotation greater tubercle with contact with corcoid arch to stop further abduction – but if you rotate laterally you can have further abbduction

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22
Q

Movements at “scapulothoracic” joint:

A

–> joint between scapula and thoracic wall
• Elevation and adepression
• Protration (forward)
• Upward and downwards rotation

Initial movements can occur without scapular motion

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23
Q

5 Fascia of upper limb

A
  • Superficial fascia is subcutaneous tissue
    • Deep Fascia
    • Clavipectoral fascia (deep to pec major)
    • Deltoid fascia
    • Brachial fascia
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24
Q

• Deep Fascia

A

• Pectoral fascia invests pectoralis major

– continuous inferiorly with fascia of abdominal wall & laterally axillary fascia (floor of axilla)

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25
Q

• Clavipectoral fascia (deep to pec major)

A

– Descends from clavicle
– encloses subclavius and pectoralis minor
– inferiorly suspensory ligament of axilla (pulls axilalry fasica & skin upward during abduction of the arm to form the armpit) - it suspends/ supports axilalry fascia

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26
Q

• Deltoid fascia

A

○ Covers muscles that cover shoulders and scapula

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27
Q

• Brachial fascia

A

– encloses arm inferiorly like a sleeve

– continuous into ther forearm as the antebrachial fascia

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28
Q

Muscles of the proximal upper limb

2 regions

A
  • Pectoral Region

* Shoulder Region

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29
Q

• Pectoral Region

A

• Anterior chest wall

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30
Q

• Shoulder Region

A
  • Intrinsic: originate from scapula and/or clavicle, and attach to humerus
    • Extrinsic: originate from torso, attach to bones of shoulder
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31
Q

Pectoral muscles: pectoralis major

A

Large, fan shaped

  • P: Clavicular head
  • Sternocostal head - arise from sternum and upper costal cartillages
  • D: Lateral lip of intertubercular sulcus of humerus (between grater and lesser tubercles)
  • I: Lateral & Medial pectoral nerves

• Action : Adduct & Medially rotate humerus

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32
Q

Pectoral muscles: pectoralis major

Laterally forms

A
  • pec major forms Anterior wall of axilla
  • Deltopectoral groove – where cephalic vein runs
  • Clavipectoral (deltopectoral) triangle – deltoid ,pectoralis major and clavicle
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33
Q

Pectoral muscles – pectoralis minor

A

• Triangle shaped

  • P: 3rd-5th ribs anteriorly
  • D: Coracoid process of scapula
  • I: Medial pectoral nerve (C8, T1)
  • Action: Helps stabilise scapula
  • Can help with inspiration – by elevating ribs
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34
Q

Pectoral muscles: subclavius

A
  • P: 1st rib
  • D: Inferior surface of middle of clavicle
  • Innervated by its own nerve : Nerve to subclavius (C5, C6 from root)
  • Action: Anchors and depresses clavicle
    • Stabilise sternoclavicular joint
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35
Q

Pectoral Muscles: Serratus anterior (L. serratus, saw)

A

• forms Medial wall of axilla

  • P: Lateral parts of 1st-8th ribs
  • D: Medial border of scapula
  • I: Long thoracic nerve (C5, C6, C7)

Muscle attaches to medial edge

• Action : On the scapula
– Protracts
– Anchors scapula against wall
– Rotates (inf part)

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36
Q

Extrinsic shoulder muscles – trapezius

A

Large muscle
• 3 parts – superiod/descending, trasnvers/middle, assencding/middle

  • P: Skull, nuchal ligament & spinous processes of thoracic vertebrae,
  • D: clavicle, acromion & spine of scapula
  • I: Spinal accessory (CN XI) and some C3, C4
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37
Q

Extrinsic shoulder muscles – trapezius

Action?

A

– Middle (or all together) retract scapula
– Descending elevates
– Ascending depresses
– Ascending and descending work in different directions and so they rotate glenoid cavity

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38
Q

Extrinsic Shoulder Muscles: Latissimus Dorsi (L. Widest of back)

A

• Large fan shaped

  • P: Spinous processes of lower thoracic vertebrae (T6-12), thoracolumbar fascia & iliac crest
  • D: Floor of intertubercular sulcus of humerus
  • I: Thoracodorsal nerve (C6, C7, C8)

• Action: Extends, adducts, medial rotates humerus

Latissmus dorsi is between pec major and teres major

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39
Q

Extrinsic Shoulder Muscles: Levator scapulae

A

• Strap muscle

  • P: Transverse processes of C1-C4 vertebrae
  • D: Superior/ Medial border of scapula
  • I: Dorsal scapular (C4,5)
  • A: Elevates (or fixes) scapula and rotates glenoid cavity inferiorly
  • Can contribute to neck movements
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40
Q

Extrinsic Shoulder Muscles: Rhomboids

A

Deep to trapezius (Major is 2x wider)
2 rhomboids one each side

  • P: Spinous processes of C7 -T5
  • D: Medial border of scapula
  • I: Dorsal scapular (C4,5)
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41
Q

Extrinsic Shoulder Muscles: Rhomboids

Action

A

• Action : On scapula
– Retract
– Fix scapula to thoracic wall
– Rotate glenoid cavity inferiorly

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42
Q

Intrinsic Shoulder Muscles: Deltoid

A

• Forms rounded contour of shoulder – looks like an innverted delta

  • P: Lateral clavicle, acromion and spine of scapula
  • D: Deltoid tuberosity of humerus
  • I: Axillary nerve
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43
Q

Intrinsic Shoulder Muscles: Deltoid

Action?

A

– Anterior: flexes and medially rotates arm (helps pec major)
– Posterior: extends and laterally rotates
– Middle: abducts arm (also if all together)
Anterior and posterior – swinging movement when walking

Note abduction:
supraspinatus initiates first 15degrees
Then deltoid helps with abduction of arm

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44
Q

Axillary nerve (C5,6)

A

Supplies
• Deltoid
• Regimental skin patch overlying it

Fracture at axillar neck and result in axillary nerve palsy

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45
Q

Intrinsic Shoulder Muscles: Teres Major

A

• Part of post axillary fold

  • P: Post surface of inferior angle of scapula
  • D: Medial lip of intertubercular sulcus of humerus
  • I: Lower subscapular nerve (C5, C6)
  • Action: Adducts and medially rotates
  • Helps with extension
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46
Q

Extrinsic shoulder muscles

A

Trapezius
Latissmus dorsi
Levator scapulae
Rhomboid

47
Q

Pectoral muscles

A

Subclavius
Pec minor
Pec major
Serratus anterior

48
Q

Intrinsic muscles

A

Deltoid

Teres major

49
Q

Rotator Cuff Muscles - names. SITS

A
  • Supraspinatus
    • infraspinatus
    • Teres minor
    • Subscapularis (inserts anterior to lesser tuberlce, the other 3 insert into greater tibercle)
50
Q

Rotator Cuff Muscles

Purpose

A
  • 4 muscles that originate from scapula and attach to humeral head – from rotator cuff
  • Reinforce joint capsule
  • Muscles ‘pull’ humeral head into glenoid fossa
  • => Protects joint & gives it stability
51
Q

Rotator Cuff Muscle: Supraspinatus

A

Not actually a rotator but is an abductor

  • P: Supraspinous fossa of scapula
  • D: (Superior facet of) greater tubercle of humerus
  • I: Suprascapular nerve (C4,5,6)

• A:
– Initiates (0-15o)
– Assists deltoid (15-90o) In Abduction

52
Q

Rotator Cuff Muscle: Infraspinatus

A
  • P: Infraspinous fossa of scapula
  • D: (Middle facet of) greater tubercle of humerus
  • I: Suprascapular nerve (C5,6)

• A: Laterally rotates arm

Artery goes over and nerve goes under

53
Q

Rotator Cuff Muscle: Teres Minor

A

• Sometimes difficult to distinguish from infraspinatus

  • P: Middle part of lateral border of scapula
  • D: (Inferior facet of) greater tubercle of humerus
  • I: Axillary nerve (C5,6)

• A: Laterally rotates arm

Traingular interval – that profunda brachii and radial nerve pas through

54
Q

Rotator Cuff Muscle: Subscapularis

A

• Forms part of posterior wall of axilla

  • P: Subscapular fossa
  • D: Lesser tubercle of humerus
  • I: Upper and lower subscapular nerves (C5,6,7)

• A: Medially rotates arm

55
Q

Arm compartments

A
  • Medial and lateral intermuscular septa extend from deep surface of brachial fascia and attach to to humerus
  • Divide arm into anterior (flexor) and posterior (extensor) compartments
56
Q

Anterior Compartment:

Proximal

A

• P: 2 heads from scapula
– Short: Coracoid process
– Long: Supraglenoid tubercle (superior to glenoid cavity)
• Long tendon crosses within cavity of joint (surrounded by synovial membrane), descends in intertubercular sulcus

57
Q

Anterior Compartment:

Distal

A

• D: Bellies of the 2 heads unite in middle of arm.
2 insertions of the muscle
– tuberosity of radius via biceps tendon
– fascia of forearm via bicipital aponeurosis

58
Q

Anterior Compartment:

Innovation

A

Tan – tendon, artery, nerve
• Bicipital aponeurosis crosses tendon and nerve

• I: Musculocutaneous nerve (C5,6,7)

59
Q

Anterior Compartment:

Action

A

– Forearm supinated (palm upwards): flexor of elbow (like when carrying a tray)
– Elbow flexed & forearm pronated(palm down): powerful supinator (like when screwing a screw tight)

60
Q

Anterior Compartment: Brachialis

A
  • P: Distal half of anterior humerus (large areaa of attachment)
  • D: Coronoid process and tuberosity of ulna
  • I: Musculocutaneous nerve (C5,6) and radial nerve

Biceps inserts into radius
Brachialis inserts into ulna

• A: Most important elbow flexor – in all positions and movements

61
Q

Anterior Compartment: Coracobrachialis

A
  • P: Coracoid process of scapula
  • D: Medial surface humerus (near nutrient foramen & at level of the deltoid tubercle)
  • I: Musculocutaneous nerve (C5,6,7) – pierces it
  • A: Helps flex and adduct arm and shoulder
    • Cause a pthology if it compresses neurovascular structures in arm
62
Q

Posterior Compartment: Triceps Brachii Fusiform

A

• P: 3 heads
– Long: arises form Infraglenoid tubercle of scapula
– Lateral: arise from posterior surface of humerus and attach superior to radial groove
– Medial: arise from posterior surface of humerus and attach superior inferior to radial groove
• D: Olecranon of ulna

  • I: Radial nerve (C6,7,8)
  • A: Extend elbow
63
Q

Posterior Compartment: Anconeus

A 
Small 
• Usually partially blended with medial head of triceps 
• P: Lateral epicondyle of humerus 
• D: Lateral surface of olecranon 
• I: Radial nerve (C7,8, T1)

• A: Assists in extending forearm/ stabilises joint

64
Q

Posterior compartment

innervation

A

Radial nerve

65
Q

Brachial Artery

A
  • Continuation of axillary artery – inferior border teres major
  • starts Medial to humerus, then anterior
  • Divides into radial and ulnar arteries – under bicipital aponeurosis
66
Q

Supracondylar fracture

A

Supracondylar fracture – in young children = damage brachial artery and no pulse distal to it.

67
Q

Brachial artery _ branches

A
  • Profunda brachii artery
  • Humeral nutrient artery
  • many muscular branches
68
Q

Superior Ulnar collateral artery

A

anastomoses with posterior ulnar recurrent

69
Q

• Inferior Ulnar collateral artery

A

anastomoses with anterior ulnar recurrent

70
Q

Profunda Brachii Artery

A

Supplies posterior compartment muscles

• Accompanies radial nerve in radial groove

Complex branching into
• Radial Collateral A: continues with radial nerve anterior to septum and lateral epicondyle, anastomoses with radial recurrent artery

Collateral and recurrent arteries form a peri- articular anastomoses of the elbow
– allows blood to reach forearm even when flexion compromises flow in distal brachial artery

71
Q

Musculocutaneous Nerve

A
  • Supplies all 3 muscles of anterior compartment (BBC)
    • Biceps
    • Brachialis
    • Coracobrachialis
  • Pierces coracobrachialis
  • Continues between biceps and brachialis (anterior to brachialis)
  • Emerges lateral to biceps as lateral cutaneous nerve of forearm
72
Q

Median nerve

A
  • start Lateral to artery, crosses to medial side at midpoint of arm
  • Lies deep to bicipital aponeurosis in cubital fossa
73
Q

Ulnar nerve

A
  • Medial to artery ‘
  • Middle of arm, pierces medial intermuscular septum (to go from anterior to posterior compartment)
  • Descends between septum and triceps
  • Passes posterior to medial epicondyle
74
Q

Radial nerve

A

• Supplies all muscles in posterior compartment
• Posterior to artery
• Early branches to long and medial heads
Continuation of posterior cord of brachial plexus

• Through Triangular Interval
– Inferior to teres major
– between long head of triceps & humerus

  • Descends inferolaterally in radial groove (profunda brachii)
  • Muscular branches
  • Pierces lateral intermuscular septum
  • Divides into deep and superficial branches
75
Q

Veins

A

Basilic and cephalic vein pierce deep fascia

Cephalic vein pierces the clavy pectoral fascia to become deep

76
Q

6 Common conditions of the shoulder

A
  • Dislocation
  • Clavicle fracture
  • Impingement
  • Calcific supraspinatous tendonitis
  • Adhesive capsulitis (‘frozen shoulder’)
  • Osteoarthritis
77
Q

Shoulder dislocation

A

• Common shoulder pathology presenting at the Emergency department with pain and visible deformity
○ But it can easily be missed

78
Q

. Shoulder stability

A
  • Suction cup effect of the labrum around the humeral head

* Negative intra-articular pressure within the joint

79
Q

Static stabilisers

A
  • Static stabilisers – glenoid labrum, joint capsule, ligaments
  • Dynamic stabilisers – rotator cuff muscles, biceps
80
Q

Directions of dislocations

A
  • Anterior = most common
  • Posterior
  • Inferior
  • 60% risk of recurrence overall
  • Risk decreases with age
81
Q

Anterior dislocation - how it happens

A

Occurs when
• Usually occurs when the arm is abducted and externally rotated ( hand behind head position)
• External force on the arm in the posterior direction pushing the head antero-inferiorly
OR • Direct blow to the shoulder from posteriorly

82
Q

Anterior dislocation - subcoracoid

A

• Subcoracoid– the humeral head sits anterior and inferior to the coracoid (60%)

83
Q

Anterior dislocation - subglenoid

A

• Subglenoid (anteroinferior) – humeral head is inferior and slightly anterior to the glenoid. The head also migrates medially (adducted bump, down)

84
Q

Clinical presentation of anterior dislocation

A

Loss of shoulder contour – not smooth round
Arm is slightly abducted and forearm internally rotated
Contra-lateral hand supports affected arm

85
Q

Posterior dislocation - mechanisms of injury

A 
• Violent shoulder contraction 
	- Epileptic seizure 
	- Electrocution 
	- Lightening strike
• Blow to anterior shoulder 
• Arm flexed across body and pushed posteriorly
86
Q

Clinical presentation of posterior dislocation

A
  • Squaring of the shoulder
    • Arm adducted and internally rotated
    • Prominent coracoid process
    • Humeral head may be prominent posteriorly – so you can feel the coracoid or feel humerul head on the back
87
Q

Scapular view

A
  • Humeral head should normally be at the ‘ glenoid (bifurcation of the Y)
    • Normally this would be to painful for patient
    • Head is out
88
Q

Inferior dislocation

A
  • Rare – 0.5% of cases
  • Hyper abduction injury
  • High incidence of associated injuries:-
  • Nerves 60%
  • Rotator cuff 80%
  • Vascular 3%

Head moves down into brachial plexus in axilla

89
Q

Associated injuries with dislocations

A
  • Fractures in approximately 30% of cases – humeral head, greater tuberosity, clavicle
    • Hill Sach’s lesion – 2/3 compression of the humeral head posterolaterally
    • Bankart’s lesion – capsule/labral disruption from the glenoid
  • Glenohumeral damage
  • Rotator cuff injury – more common in elderly
  • Nerve injury – most commonly the axillary nerve
  • Vascular injury – axillary artery (rare)
90
Q

Treatment of clavicle fractures

A
  • Most treated nonoperatively with a sling or cuff and collar
    • Sling given if fracture is more distal

• Some need surgical fixation

  • Displacement with tenting of the skin
  • Open fracture
  • Neurovascular compromise
  • Floating shoulder
  • Muscle interposition – if muscle is in the way bones can’t heal
91
Q

Complications of clavicle fractures

A 
• Non-union 
• Malunion 
• Infection (open fracture) 
• Nerve damage 
	- Suprascapular 
	- Supraclavicular
	 - Trunks and divisions of brachial plexus 
• Vascular – subclavian vessels 
• Pneumothorax
92
Q

Rotator cuff tears

A

Acute (trauma) /Chronic (degenerative microtrauma)

• Supraspinatous is the most commonly one involved as it is under the coraco-acromial arch

93
Q

Rotator cuff tears- risk factors

A 
• Age 
• Recurrent overhead activity
 - Painters 
- Athletes 
– swimming, tennis,weightlifting
  • Shoulder osteoarthritis with osteophytes = rub on cuff to give a tear
  • Acromial shape variants
94
Q

Supraspinatous tears - clinical presentation

A

• Can be asymptomatic
• Most commonly – anterolateral shoulder pain radiating down the arm
• Worsened by activity (present at rest)
- Overhead activity
- Leaning on the elbow/pushing out of a chair (displaces the shoulder superiorly
- Reaching forward
• May complain of weakness of shoulder abduction

95
Q

Supraspinatous tears - treatment

A
  • Treatment depends on symptoms and underlying pathology

* Variable - physiotherapy, injections (to relieve pain), arthroscopic /open repairs and grafts

96
Q

Impingement syndrome

A

Bony and soft tissue injury

• Involves supraspinatous impinging on the undersurface of the coraco-acromial arch

97
Q

Impingement syndrome

Causes

A

• Caused by anything that narrows the subacromial space

  • Thickening of the coraco-acromial ligament
  • Inflammation of supraspinatous tendon
  • Subacromial osteophytes
98
Q

Impingement syndrome

Treatment

A

Treatment – can be surgery and physiotherapy

99
Q

Calcific supraspinatous tendonitis

A
  • Deposition of hydroxyapatite crystals in supraspinatous tendon
  • Pain on abduction / flexion of the shoulder - Reduced coraco-acromial space
100
Q

Calcific supraspinatous tendonitis

Clinical symptoms

A
  • Stiffness
  • Snapping sensation
  • Catching of muscle
  • Reduced range of movement
101
Q

Pathology – calcific tendinitis

A
  • Theory 1
    • Regional hypoxia
    • Tenocytes –>chondrocytes
    • Endochondral ossification
  • Theory 2
    • Metaplasia of mesenchymal stem cells into osteogenic cells
    • Ectopic bone formation
  • Crystalline in the resting phase
  • Reabsorbed by phagocytes (‘toothpaste’)
  • Reabsorption phase most painful
102
Q

Calcific supraspinatous tendintis

4 stages

A

Pre-calcific –> Formative –> Resorptive –> Postcalcific

During the resorptive phase it is reabsorbed by phagocytes becoming ‘toothpaste’ like. This is the most painful phase.

103
Q

Calcific supraspinatous tendintis treatment

A

• Non-operative

  • NSAIDs, physical therapy, steroid injections
  • Extra-corporeal shock-wave therapy
  • Ultrasound guided needle lavage/barbotage = use needle to squeeze them out

• Operative - Surgical decompression of calcium deposit

104
Q

Adhesive capsulitis ‘Frozen shoulder’

A
  • Disabling condition involoving the glenohumeral joint which is stiff and inflammed
    • Very painful takes about 2 years to fix on its own
105
Q

Adhesive capsulitis – diagnostic criteria (Codman)

A
  • Global restriction of shoulder movement
  • Idiopathic aetiology
  • Usually painful at the outset
  • Normal x-ray
  • Limitation of external rotation and elevation
106
Q

Adhesive capsulitis Risk factors

A
  • Female – 4th/5th decade
  • Shoulder trauma
  • Epilepsy
  • Cardiac/lipid anomalies
  • Diabetes mellitus (x2-4 increased risk)
  • Endocrine disease
  • particularly hypothyroidism
  • Drugs
107
Q

Adhesive capsulitis - treatment

A
  • Analgesia
  • Physiotherapy
  • Distension injections – needle into joint and inflate it
  • Steroid injections – relieve inflammation and help pain
  • Manipulation under anaesthesia
  • Arthroscopic/open release
108
Q

Adhesive capsulitis - stages

A
  • 3 stages over an average of 2 years
    • Freezing (3 months)
    • Frozen (3-9 months, pain at extreme range of movement and marked stiffness)
    • Thawing (9-18 months, painless and stiff – starts to resolve so start therapy)
    90% of shoulder motion regained
109
Q
A

glenohumeral and acromioclavicular joints

Glenohumeral Arthritis
• More common in women and increases with age

110
Q

Causes of secondary Osteoarthritis

A
  • Post-traumatic
    • Post dislocation
    • Inflammatory / crystalline arthritis
    • Osteonecrosis
    • Neuropathic
    • Rotator cuff arthropathy
111
Q

Acromioclavicular Arthritis

A

—> Due to transmission of large axial loads through a small contact area causing repetitive microtrauma • More common with age but can occur in second decade

112
Q

Acromioclavicular Arthritis

Risk factors

A
  • Trauma
  • Distal clavicle osteolysis
  • Inflammatory arthropathy
  • Post-infection
  • Associated with individuals who perform increased overhead activities eg weight lifters/sportsmen
113
Q

Osteoarthritis treatment

A 
• Activity modification 
• Analgesia 
• Steroid injections 
• Surgery 
- Excision of distal clavicle (AC joint) 
- Arthroplasty (Glenohumeral)

Y1 TP2 Musculoskeletal System (10 decks)

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