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Sports Medicine > Injuries of the Upper Limb > Flashcards

Injuries of the Upper Limb Flashcards

1
Q

What type of injuries is the shoulder more prone to?

A

Soft tissue, rather than bony

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2
Q

What is the pathology of a rotator cuff (RC) injury?

A

Inflammation of RC, associated bursitis & impingement of RC against CA ligament

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3
Q

What is the mechanism of a RC injury?

A

Repetitive microtrauma - intensity, frequency and duration of training load exceeds ability of tissue to recover and adapt

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4
Q

What are the pathomechanics of a RC injury?

A

1) Wringing out of blood supply in supraspinatus and biceps tendon on internal rotation & adduction
2) Impingement of RC against CA ligament
3) Narrowing of subacromial canal
4) Role of muscle imbalance

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5
Q

What is the history of a RC injury?

A

Pain with/after activity, pain with overhead activity, pain lying on shoulder

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6
Q

What is considered in the examination of an RC injury?

A

Painful arc of movement (80-120 degrees abduction), positive impingement signs

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7
Q

What investigations are used for a RC injury?

A

X-ray, ultrasound, MRI

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8
Q

How is an RC injury graded?

A

Grade I: Pain after activity
Grade II: Pain during/after activity
Grade III: Prolonged pain throughout the day

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9
Q

What is the pathology of the RC injury grades?

A

Grade I: Inflammation of tendon
Grade II: Partial tear
Grade III: Complete tear

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10
Q

What is the treatment for an RC injury?

A

Reduction of activity, NSAIDs, physio, address muscle imbalances, surgery (arthroscopy or open)

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11
Q

What is the mechanism of a GH dislocation?

A

Actue injury, fall onto point of shoulder/outstretched hand, abduction and external rotation

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12
Q

What is considered in the examination of a GH dislocation?

A

Obvious deformity, pain, loss of function of arm

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13
Q

What investigation is used for a GH dislocation?

A

X-ray

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14
Q

What is the treatment for a GH dislocation?

A

Reduction, further investigation (MRI), long-term (conservative vs surgery)

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15
Q

What is the mechanism of a GH sublaxation?

A

Partial dislocation, articular surfaces remain in partial contact with each other but no longer aligned

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16
Q

What is the history of a GH sublaxation?

A

Pain with activity, feeling of instability, dead arms with trauma

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17
Q

What is considered in the examination of a GH sublaxation?

A

Pain in the apprehension position, increased GH translation

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18
Q

What investigation is used for a GH sublaxation?

A

X-ray, MRI

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19
Q

What is the treatment for a GH sublaxation?

A

Conservative: Strength of RC, scapula stabilisers

Surgery

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20
Q

What is the glenoid labrum?

A

Fibrocartilage rim surrounding the articular surface of the glenoid

21
Q

What is the mechanism of a glenoid labrum injury?

A

Associated with dislocation/sublaxation and acute trauma, SLAP lesion

22
Q

What is the history of a glenoid labrum injury?

A

Shoulder pain with activity, may be acute or painful click

23
Q

What is considered in the examination of a glenoid labrum injury?

A

Pain with overhead activities, positive O’Brien test

24
Q

What investigation is used for a glenoid labrum injury?

A

MRI anthrogram, arthroscopy

25
Q

What is the treatment for a glenoid labrum injury?

A

Surgery (arthroscopy or open)

26
Q

What is the mechanism of an AC joint injury?

A

Fall onto point of shoulder

27
Q

What is the history of an AC joint injury?

A

Mechanism, pain especially with overhead/cross body activities

28
Q

What is considered in the examination of an AC joint injury?

A

Tender over AC joint, deformity

29
Q

How is an AC joint injury graded?

A

Grade I: No widening of joint
Grade II: Partial widening of joint
Grade III: Complete rupture of joint

30
Q

What is the treatment for an AC joint injury?

A

Grade I: Rest, ice, NSAIDs, strength, physio, corticosteroid injection (takes 10-14 days)
Grade II: As above (takes 4-6 weeks)
Grade III: Treated conservatively or surgically (takes 3 months)

31
Q

What is the mechanism of a clavicle fracture?

A

Fall onto outstretched hand, direct blow, fall onto point of shoulder

32
Q

What is the history of a clavicle fracture?

A

Mechanism, immediate pain, deformity

33
Q

What is considered in the examination of a clavicle fracture?

A

Obvious deformity, tenderness, pain with movement of arm

34
Q

What investigation is used for a clavicle fracture?

A

X-ray, CT scan

35
Q

What is the treatment for a clavicle fracture?

A

Usually conservative - sling for 6 weeks, mobilise elbow hand & wrist
Surgery - plate, pin

36
Q

What is lateral epicondylitis?

A

Inflammation of the lateral epicondyle at insertion of the common extensor tendon (tennis elbow)

37
Q

What is the mechanism of lateral epicondylitis?

A

Overload of the bony insertion due to repetitive micro trauma, tightness in the extensor muscles of the forearm and hand

38
Q

What is the history of lateral epicondylitis?

A

Pain, tenderness, feeling weak with grip

39
Q

What is considered in the examination of lateral epicondylitis?

A

Tender lateral epicondyle, pain with resisted wrist and finger extension

40
Q

What is the treatment for lateral epicondylitis?

A

Ice, NSAIDs, corticosteroid injection, graded eccentric strength program

41
Q

What are the contributing factors of lateral epicondylitis?

A

Grip size, compression of common extensor tendon, technique, racquet size

42
Q

What is medial epicondylitis?

A

Inflammation of the medial epicondyle at the insertion of the common flexor tendon (golfer’s elbow)

43
Q

What is forearm insertion syndrome?

A

Inflammation of radial wrist extensors and/or thumb extensors

44
Q

Why may scaphoid fractures not heal properly?

A

Limited blood supply - risk of avascular necrosis

45
Q

What is the mechanism of a scaphoid fracture?

A

Fall onto outstretched hand

46
Q

What is the history of a scaphoid fracture?

A

Mechanism, pain in wrist with activity

47
Q

What is considered in the examination of a scaphoid fracture?

A

Tender in anatomical snuffbox

48
Q

What investigations are used for a scaphoid fracture?

A

X-ray, CT, MRI

49
Q

What is the treatment of a scaphoid fracture?

A

Scaphoid plaster, repeat x-rays, plaster immobilisation/surgery

Sports Medicine (15 decks)

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