MSK: Shoulder (UE Conditions) Flashcards
Difference between tendinitis and tendinosis
(1) Inflammation; acute
(2) Degeneration; chronic
Happens to weekend warriors
Supraspinatus tendinitis
Due to eccentric load and is common in pitchers
Bicipital tendinitis
Impingement among older pts (>40 y/o);
degenerative changes d/t stress overload – repetitive movements
Primary impingement
Impingement among younger pts. (15-35 y/o);
due to altered muscle dynamics – hyperactivity or weakness
Secondary impingement
Common in overhead athletes;
impingement in the area of the labrum
Internal impingement
- contact of undersurface of rotator cuff with the posterosuperior glenoid labrum when the arm is full ER and 90 abd.
Neer’s Stages of Shoulder Impingement
STAGE I - Inflammation + Edema + Hemorrhage
STAGE II - Fibrosis + Tendonitis
STAGE III - Partial or full thickness tear; Tendon degeneration & rupture
STAGE IIIA - < 1 cm
STAGE IIIB - > 1 cm
STAGE IV Multiple tendon tear
Jobe’s Classification of Shoulder Impingement
GRADE I - Pure impingement without instability (older pts)
GRADE II - Secondary impingement and instability due to chronic capsular and labral microtrauma
GRADE III - Secondary impingement and instability caused by generalized
hypermobility or laxity
GRADE IV - Primary instability with no impingement
Pain only with movement, significant adhesions, LOM with substitute motions of the scapula. Notable atrophy. (9-15 mos)
Frozen stage of Ad Caps
Persistent, more intense pain even at rest. LOM in all directions, cannot be restored with intra-articular injection (3-9 mos)
Freezing stage of Ad Caps
Minimal pain, no synovitis but significant capsular restrictions. Motions may gradually improve. (15-24 mos)
Thawing stage of Ad Caps
Common MOI for Traumatic Shoulder Dislocation
Abduction and External Rotation
Most common direction of instability. subluxation, or dislocation
Anterior (+ inferior)
Superior labrum - anteroposterior - SLAP lesion
Bankart lesion
