Common Shoulder Problems Flashcards
Which type of shoulder dislocation is easily seen?
Traumatic anterior dislocation
Why is posterior dislocation often missed?
It is rare, not easy to see on an Xray.
How do patients with posterior dislocation of the shoulder present?
With shoulder pain, usually holding arm in internal rotation. Unable to externally rotate.
What causes posterior dislocation of the shoulder?
Caused by the surrounding muscles such as the rotator cuff muscles contracting so hard that they pull the structures off the joint and dislocate it e.g. electric shock or seizure.
What is a comminuted fracture?
A comminuted fracture is a break or splinter of the bone into more than two fragments. Since considerable force and energy is required to fragment bone, fractures of this degree occur after high-impact trauma such as in vehicular accidents.
What happens in a displaced fracture?
Not just a crack in the bone, joint becomes unstable since the parts have moved apart and are no longer correctly aligned.
What is the treatment for a clavicular fracture?
Treatment varies, sometimes they can be left to heal, other times they need fixing. Clinical trials are required to access risk and benefit.
What is calcific tendinitis?
A degenerative condition in which there is a calcium hydroxyapatite deposit (CHD) in tendons (commonly in rotator cuff tendons). They can cause sudden attacks of painful inflammation due to a build up of pressure and chemical irritation.
What happens if the CHD in the shoulder is large?
Subacromial impingement. It can also burst leading to acute calcific tendinitis. Gives extreme pain for 1-2 weeks and then usually resolves on its own.
What is ‘popeye muscle’?
Long head of the biceps ruptures. Lose partial attachment for the muscle but it is still attached at the short tendon of biceps and so can still function.
What causes the long head of the biceps to rupture?
Often occurs in old age due to overuse, wearing down or degeneration of the tendon. Can also occur from sudden contraction of the biceps with resistance to flexion e.g. lifting something heavy.
What causes impingement in the sub-acromial bursa?
Inflammation within the bursa, inflamed or large tendon or a more curved acromion.
What would an examination of impingement in the sub-acromial bursa show?
No pain in full abduction of the arm (structures move beneath acromion. Positive Hawkins test. Ultrasound scan might show bursitis, tendinopathy or dynamic impingement.
How do you treat sub-acromial impingement?
Steroids and physic or surgical decompression
What is a rotator cuff tear?
A tear in one or more of the tendons of the rotator cuff muscles.
