Common Pathologies of the Upper Limb 1

Question 1

RCRSP includes which conditions…

Answer 1

Sub-acromial pain syndrome
RC tendinopathy
RC tears

Question 2

What is the most accepted theory in RCRSP

Answer 2

Tendon compression between greater tuberosity and superior aspect of glenoid

Question 3

What are the risk factors for RCRSP

Answer 3

> 50, diabetes, consistent work with shoulder above 90 degrees

Question 4

Describe the clinical presentation of RCRSP

Answer 4

Pain and impairment of shoulder movement and function, usually during shoulder elevation and lat rotation

Question 5

What two changes to shoulder mechanics are supported by evidence in RCRSP

Answer 5

altered scapular movement; delayed activity of lower traps

increased superior glide of humeral head in glenoid

Question 6

Which population is most at risk of Tennis Elbow (lateral epicondylitis)

Answer 6

Male = female
40s/50s
Smoking and obesity are risk factors

Question 7

What are the most common tendons affected in Tennis Elbow

Answer 7

ECRB

Then ECRL, Sup, ED, EDM, ECU

Question 8

What is the clinical presentation of Tennis Elbow

Answer 8

Pain around LE, usually radiated in line with extensors, aggravated by resisted wrist (or middle finger) extension or forearm supination, gripping or stretching tendon can reproduce symptoms

Question 9

What population is most at risk of Golfers’ Elbow (Medial epicondylitis)

Answer 9

40-60 y
Female > male
Associated with golf, manual workers

Question 10

What structures are most often involved in golfers’ elbow

Answer 10

PT, FCR
Ulnar nerve (20%)

Question 11

What is the clinical presentation of golfers’ elbow?

Answer 11

Pain on medial aspect of elbow, aggravated be resisted/ repetitive wrist flexion or pronation, valgus stress, throwing, gripping

Question 12

Describe De Quervains’ Tenosynovitis

Answer 12

Thickening of tendon sheath around EPB and APL, may involve eccentric lowering of wrist into ulnar deviation with load, more common in women, 40-50s

Question 13

What is the clinical presentation of DQT

Answer 13

Pain on radial side of wrist that can refer into thumb, aggravated by resisted thumb extension, abduction or by stretching affected tendons (Finkelstein test), pain on palpation

Question 14

Describe carpal tunnel

Answer 14

Most common peripheral nerve entrapment, median nerve is compressed in carpal tunnel

Question 15

What are the risk factors for carpal tunnel

Answer 15

Female> Male, increasing age, diabetes, menopause, hypothyroidism, obesity, arthritis, pregnancy

Question 16

Describe the clinical presentation of carpal tunnel

Answer 16

Intermittent nocturnal parenthesia, which increases in frequency and then develops into waking hours
May be weakness of median nerve innervated muscles, atrophy
Can progress to difficulty with fine motor tasks