Kapitel 50 - The shoulder

Question 1

Name the active and passive stabilisers of the shoulder

Answer 1

Passive = limited joint volume, adhesion/cohesion mechanisms, concavity compression and
capsuloligamentous restraints.

Active = muscular action, most importantly supraspinatus, infraspinatus, subscapularus and
teres minor.

Question 2

2. Which statement(s) is/are true?
   I. The more severe the thoracic limb lameness is, the lower the chance that it originates from the
   shoulder compared to the elbow
   II. Periarticular calcifications around the shoulder in the lame thoracic limb are accompanied by
   other shoulder or elbow pathologies in 90%

Answer 2

I is false, II is true

Question 3

When performing artrodesis of a shoulder with a grossly normal shaped glenoid and humeral
head, how much of these structures is removed?

Answer 3

Glenoid and humeral head: removal of just the cartilage while retaining the concave and
convex surface

Question 4

A small breed dog, 8mo, presents with thoracic limb lameness. Below is the radiograph of his
shoulder. What is your diagnosis and what are the treatment options (2)?

Answer 4

Diagnosis:
Glenoid dysplasia
Treatment:
– artrodesis
– glenoid excision / excision arthroplasty
Medical management is not recommended

Question 5

Name the three physical examination techniques for biceps tendinopathy

Answer 5

– Biceps tendon test (digital pressure on the biceps tendon while flexing the shoulder and extending
the elbow). Note, in the German literature, this name is used for the test to evaluate rupture of the
tendon, with full flexion of the shoulder and full extension of the elbow, which should be possible.
– Shoulder drawer test (cranial translation of the humerus to put pressure on the biceps tendon and
associated sheeth
– Biceps retraction test (grasping the insertion of the biceps near the elbow and pulling caudally
with the dog in a weight-bearing stance (reported not to be specific for biceps tendon disease).

Question 6

What is the most common direction of shoulder (sub)luxations?

Answer 6

Medial

Question 7

Which of the following muscles is affected by contracture most commonly?

Answer 7

Infraspinaturs

Question 8

What are the reported abduction angles in normal
dogs and dogs affected by medial shoulder instability?

Answer 8

Normal: 30

Shoulder instability: 50

Question 9

Which statement(s) is/are true?
I. When there is severe stretching of the medial joint capsule, subscapularis tendon imbrication
should be reinforced with medial glenohumeral ligament augmentation

II. In human should instability, artroscopic thermal capsulorraphy has become common

Answer 9

Both are false

Question 10

Which MRI sequence is mentioned as neccessary besides T2-weighted images?

Answer 10

Proton density fat saturation