Ortho Shoulder Injuries

Question 1

Typical Presentation of pt w/ anterior shoulder D/L

Answer 1

Arm ABducted & externally rotated

Squared off shoulder

Question 2

Workup for Ant Shoulder D/L

Answer 2

Axillary, AP and Y view X rays

Question 3

Bankart Lesion

Answer 3

fracture of the anterior inferior glenoid following impaction of the humeral head against the glenoid.

Question 4

Hill-Sachs Lesion

Answer 4

compression chondral injury of the posterior superior humeral head following impaction against the glenoid

Question 5

MC nerve injury possibility in Ant Shoulder D/L

Answer 5

axillary nerve injury: numbness/tingling over lateral shoulder (deltoid region)

Question 6

Workup for torn Rotator Cuff

Answer 6

MRI

Question 7

MC injured muscle in Clavicle Fx

Answer 7

supraspinatus

Question 8

Mc fracture of clavicle

Answer 8

Middle 1/3rd

Question 9

skin tenting is present in this Fx

Answer 9

clavicle fracture

Question 10

Workup for clavicle Fx

Answer 10

AP and clavicle view X ray

Question 11

Tx for clavicle Fx

Answer 11

simple arm sling or figure 8 sling for 4-6 wks

Ortho consult if proximal 1/3rd

Begin PT after 4 weeks/light strengthening

Question 12

pain with cross chest testing

Answer 12

AC joint separation

Question 13

step off deformity

Answer 13

elevation of the clavicle

Question 14

Tx for grade I and II AC joint separation

Answer 14

sling + analgesia

Question 15

Tx for grade III AC joint separations

Answer 15

surgery

Question 16

Positive Yergason test

Answer 16

biceps tendonitis

Question 17

What is the yergason test

Answer 17

externally rotate and press downward on flexed elbow

Question 18

ant shoulder pain, worse w/overhead activities

maximal pain with palpation b/w greater and lesser tubercle

Answer 18

Biceps tendonitis

Question 19

popeye deformity

Answer 19

biceps tendon rupture

Question 20

Workup for Biceps Tendonitis

Answer 20

X ray to r/o Fx

MRI: increased T2 signal

Question 21

Most rotator cuff tears occur in what muscle

Answer 21

supraspinatus

Question 22

Unable to lie on shoulder at night

dx?

Answer 22

rotator cuff tear

Question 23

shoulder pain with overhead activity or at night when lying on arm or weakness and immobility after acute injury.

Answer 23

Rotator cuff tear

Question 24

preferred test for rotator cuff tear

Answer 24

MRI

Question 25

Tx for biceps tendonitis

Answer 25

NSAIDS PT strengthening, steroid injections

Question 26

complete rotator cuff tear Tx

Answer 26

surgery

Question 27

Physical Exam tests for supraspinatus tear (rotator cuff tear)

Answer 27

Empty can test

Full can test

Arm Drop

Question 28

Pt with adhesive capsulitis could have what underlying conditions?

Answer 28

DM or hypothyroidism

Question 29

absent axillary recess

Answer 29

adhesive shoulder

Question 30

Insidious onset of shoulder stiffness and pain at rest and with movement. Decreased active and passive range of motion.

Answer 30

adhesive capsulitis

Question 31

positive apley scratch test

Answer 31

adhesive capsulitis

Question 32

adhesive capsulitis tx

Answer 32

NSAIDS PT

Question 33

what will an x ray for adhesive capsulitis show?

Answer 33

proximal migration of the humeral head

Question 34

What are the three positive impingement tests

Answer 34

Neer test

Hawkins test

Drop Arm Test

Question 35

Tx for subacromial impingement

Answer 35

RICE, NSAIDS

Question 36

X ray shows subcondral sclerosis and osteophytes

Answer 36

osteoarthritis

Question 37

Tx for arthritis

Answer 37

Cox-2 inhibitors (NSAIDS)