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U1 PBT LGS > LGS 2 > Flashcards

LGS 2 Flashcards

1
Q

What injuries are included in a SAPS (subacromial pain syndrome) diagnosis?

A
  • Bursitis
  • Tendinosis calcarean
  • Supraspinatus tendinopathy
  • Partial tear of the rotator cuff
  • Biceps tendinitis
  • Tendon cuff degeneration
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2
Q

SAPS is usually caused by a traumatic mechanism. True or False?

A

False.
It’s usually non-traumatic

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3
Q

Provide a brief overview of subacromial pain syndrome.

A
  • Non-traumatic
  • Usually unilateral
  • Shoulder problems that cause pain, localized around the acromion
  • Often worsening during or due to lifting of the arm
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4
Q

What are the rotator cuff muscles?

A
  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Subscapularis
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5
Q

What is the percentage of adults that have shoulder pain?
(provide a range)

A

7-34%

Incidence: around 19/1,000 person-years

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6
Q

In what population (sex & age) are shoulder injuries highest?

A
  • Females
  • Over 45 years old
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7
Q

What are the most common shoulder injuries?

A
  • Shoulder impingement syndrome
    (Subacromial bursitis & Subacromial tendinitis)
  • Rotator cuff tears
  • Biceps tendinitis
  • Rupture of long head of biceps
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8
Q

What is the prevalence of rotator cuff tears by age groups?

A
  • 9% of individuals <21 years
  • 30-50% of individuals >60 years
  • 62% of individuals 80+ years
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9
Q

What are the causes of rotator cuff injuries?

A
  • Rotator cuff tears are the result of long-term degeneration and entrapment of the rotator cuff tendons as they pass between the head of the humerus and the acromion
  • Sudden powerful elevation of the arm
  • Fall onto the shoulder
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10
Q

Why don’t younger patients usually have rotator cuff/ tendon tears?

A

Younger patients: frequently result in avulsion of bone because their tendons are normal strength

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11
Q

What are some risk factors associated with SAPS?

A
  • Repetitive movements of the shoulder or hand/wrist during work
  • Work that requires much or prolonged strength of the upper arms
  • Hand-arm vibration (high vibration and/or prolonged exposure) at work
  • Working with a poor ergonomic shoulder posture
  • High psychosocial workload
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12
Q

What are some psychological risk factors for prolonged SAPS?

A
  • High psychological demands
  • Low control
  • Low social support
  • Low job satisfaction
  • High pressure to perform
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13
Q

What are some common differential diagnoses for soft tissue shoulder pain?

A
  • C-spine injury (nerve root impingement, c-spine muscle strain)
  • Elbow injury (joint sprain, muscle strain)
  • Brachial plexus injury
  • Shoulder fracture (humerus, clavicle)

*Remember to always look ABOVE and BELOW the suspected injury site!

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14
Q

What are some ways to diagnose rotator cuff using imaging? When should you do this?

A
  1. Ultrasound
    - not as expensive and just as good at detecting full RC tears
    - recommended after 6 weeks of symptoms
  2. MRI
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15
Q

What are some ways to assess shoulder injuries in the clinic?

A
  • ROM using goniometer
  • Muscle strength testing
  • Outcome measures (DASH, UEFI, Shoulder Disability Questionnaire)
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16
Q

What are some signs and symptoms of:
Rotator Cuff tendinitis, subacromial bursitis, rotator cuff tears, impingement syndromes

A
  • Pain over proximal end of humerus
  • Pain with active and/ or passive movements (depending on structure involved)
  • Pain and limited movement/strength with shoulder abduction/ER most common
17
Q

What are some signs & symptoms of:
Tenosynovitis, rupture of long head of biceps tendon

A
  • Pain in anterior aspect of the shoulder, radiating to the elbow
  • Worse pain with abduction and external rotation
  • Tenderness over the biceps tendon in the bicipital groove
18
Q

The natural course of SAPS is favourable. True or False?

A

False.
The course is unfavourable.

19
Q

What percentage of patients still have some kind of restriction and/ or pain after 1 year of SAPS?

A

After 1 year, 1/3 patients still have some kind of restriction and / or pain

~70% are free of restriction and pain after 1 year

20
Q

What is the natural progression of SAPS?

A

Tendinitis → degeneration (tendinosis) → Tears

21
Q

What are the grades of muscle/ tendon strain? Provide a brief overview of each.

A

Grade 1: mild damage to individual muscle fibers

Grade 2: more extensive damage with more muscle fibers involved; muscle is not completely ruptured

Grade 3: complete rupture of muscle or tendon

22
Q

A longer duration of shoulder pain typically leads to poorer outcomes. What is this duration? At what age does this typically occur?

A

> 3 months of shoulder pain leads to poorer outcomes

  • Ages 45-54
23
Q

What amount of time is considered “chronic” shoulder pain? What about “acute” shoulder pain?

A

Chronic: >3 months
Acute: <6 weeks

24
Q

What are some psychological factors associated with the prognosis of shoulder pain? Provide a brief explanation.

A
  1. Emotional / mental health – disability and pain
    - Lower emotional / mental health function is associated with greater pain or disability or lower physical functioning at initial evaluations
  2. Patient expectation is associated with patient –reported outcomes after treatment
    - Higher expectation of benefit, greater the perceived benefit after surgery

U1 PBT LGS (3 decks)

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