Lecture 8: Approach to Shoulder Complaint

Question 1

Shoulder Pain

Answer 1

• 3rd most common musculoskeletal complaint

- ONLY JOINT in human body where tendons (rotator cuff) pass between bones (acromion and humerus)

Question 2

Clavicle, Proximal Humerus, Scapular Fractures and what/who they are most associated with

Answer 2

Clavicle –> occurs in kids/young adults

Proximal Humerus –> most commonly in elderly

Scapular –> associated w/blunt trauma

Question 3

Most Common Acute causes of Shoulder Pain (5)

Answer 3

• Rotator Cuff Injuries
• Fractures/dislocations (clavicle/proximal humerus)
• dislocations (glenohumeral joint)
• acromioclavicular joint (sprains/tears)
• myofascial injury

Question 4

Most Common Chronic and Life Threatening causes of Shoulder Pain (6)

Answer 4

Chronic: rotator cuff disorders, adhesive capsulitis, shoulder instability/arthritis

Life Threatening: Septic Arthritis, Referred Pain (acute MI, Intraperitoneal hemorrhage, lung pathology)

Question 5

Glenohumeral Joint Dislocation

Answer 5

• 50% of all major joint dislocations
• 3 types:
  1. anterior dislocation = MOST COMMON (95-97%)
  2. posterior dislocation = 2-4%
  3. inferior dislocation = 0.5%

Question 6

Acromioclavicular Joint Injuries

Answer 6

• occurs from direct trauma to superior/lateral aspect of shoulder w/arm adducted
• AC sprain, ligament rupture, then strain/rupture of stronger coracoclavicular ligament