Painful arc syndrome Flashcards
What are some of the causes of Painful arc syndrome?
Subacromial bursitis
Supraspinatous tendonitis
What is the presentation of Painful arc syndrome?
Pain on abduction between 60 - 120
Weakness
Decreased ROM
Positive Hawkin’s test
What is Hawkin’s test?
Shoulder flexed to 90
Elbow flexed to 90
Hold patients wrist and elbow, internally rotate by lifting wrist up
Pain located below AC joint with internal rotation is positive
What investigations can be done for a patient with Painful arc syndrome?
X ray
USS
MRI Arhrogram
What are the treatments for Painful arc syndrome?
Conservative - rest, physiotherapy
Medical - NSAIDs, subacromial bursa steroid injection
Surgical - Arthroscopic acromioplasty
What is the differential for someone with Painful arc syndrome?
Impingement of supraspinatus tendon/subacromial bursa between acromion and greater tuberosity of humerus.
Supraspinatus partial or full tear
AC joint OA
What is the empty can test?
Jobes test
Used to assess supraspinatus muscle/tendon integrity
How is the empty can test performed?
Have the patient’s arm 90 elevation in the scapular plane and fully internally rotated for empty can test
45 externally rotated for full can test
Ask patient to push against resistance
Pain/Weakness = positive
What can cause a Rotator cuff tear?
Degeneration
Trauma - Sudden jolt/Fall
What are the signs of a complete Rotator cuff tear?
Shoulder tip pain
Full range of passive movement
Inability to abduct the arm unless passive to 90 then active after
Drop arm test positive
How is the drop arm test performed?
Passively abduct the arm to 90
Ask the patient to lower arm in a controlled way, let go
Positive if cannot lower in a controlled way
Tests for supraspinatus tears
What is the treatment for a complete Rotator cuff tear?
Open or arthroscopic repair
