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724: Medical Lectures > Rotator Cuff Tendinopathy > Flashcards

Rotator Cuff Tendinopathy Flashcards

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USMLE® Step 1 flashcards
1
Q

__-__% of the general population suffers from shoulder pain

A

16-34

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2
Q

Is inflammation present in RC tendinopathy?

A

Minimal role early on

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3
Q

What patieint populations are at risk for RC tendinopathy?

A

manual laborers and those whose work involves a great deal of repetitive motion

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4
Q

True or False

In the general population as well, rotator cuff disease is the most common cause of shoulder pain

A

True

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5
Q

What tendon is the most frequently injured?

A

supraspinatus

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6
Q

Other than job activities what are 4 other risk factors for RC tendinopathy?

A
  • anatomic variants
  • older age
  • high BMI
  • instability or hypermobility of the glenohumeral joint (not due to muscle weakness)
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7
Q

What does the supraspinatus do?

A

abduction and external rotation

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8
Q

What does the infraspinatus do?

A

abduction and external rotation

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9
Q

What does the teres minor do?

A

abduction and external rotation (especially when the arm is abducted to 90 degrees)

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10
Q

What does the subscapularis do?

A

internal rotation, also assists in abduction and adduction

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11
Q

True or False

There is a definitive pathophysiology and mechanism of injury for rotator cuff tendinopathy

A

False

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12
Q

What are the 2 theories of the pathophysiology and MOI for rotator cuff tendinopathy?

A
  • Biomechanical factors

- Vascular factors

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13
Q

What does an alternative approach to describing the mechanism of injury involve?

A
  • intrinsic factors, directly related to the tendon

- extrinsic factors, related to surrounding structures

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14
Q

What are 7 differential diagnoses to RC tendinopathy?

A
  • cervical radiculopathy
  • acromioclavicular osteoarthritis
  • subacromial bursitis
  • bicipital tendinopathy
  • rotator cuff tear
  • glenoid labrum tear
  • adhesive capsulitis
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15
Q

Describe the clinical presentation of a patient with RC pathology

A
  • Shoulder pain with overhead activity
  • Pain at night (especially when lying on the affected shoulder)
  • Weakness
  • Decline in performance
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16
Q

Where do patients describe pain at?

A

lateral deltoid

17
Q

What does the physical examination reveal?

A
  • muscle atrophy of the affected muscle
  • tenderness upon palpation
  • referred neck pain
  • painful ROM above 90 degrees of abduction, or pain with internal rotation
18
Q

Pain that occurs between __-__ degrees of active abduction marks a positive arc test

A

60-120

19
Q

What tests examines the supraspinatus?

A

“empty can” (Jobe’s strength) test

20
Q

What tests examines the infraspinatus?

A

resisted ER strength test

21
Q

What tests examines the subscapularis?

A

Push off (Gerber’s) test

22
Q

What are the 2 special tests to assess shoulder impingement?

A
  • Neer

- Hawkins-Kennedy

23
Q

What is considered the gold standard for the initial evaluation of tendon disorders?

A

musculoskeletal ultrasound

24
Q

Is musculoskeletal ultrasound highly specific or sensitive?

A

sensitive

25
Q

When should orthopedic referral be obtained?

A

if nonoperative therapy fails to provide relief within six to nine months or a diagnosis of rotator cuff tear is made

26
Q

What are the 3 basic surgical interventions?

A
  • debridement
  • acromioplasty with debridement
  • rotator cuff repair
27
Q

What does acute therapy involve?

A
  • Cryotherapy
  • Rest
  • NSAIDS
  • Electrical stimulation, phonophoresis and iontophoresis
  • Therapeutic Ultrasound
  • Laser
28
Q

What does subacute therapy involve?

A
  • Glucocorticoids
  • Topical Glyceryl trinitrate
  • Experimental therapy
29
Q

What do topical glyceryl trinitrates do?

A

They cause local vasodilation, increasing blood flow to the damaged tendon

30
Q

What are the 3 complications associated with RC tendinopathy?

A
  • Significant loss of shoulder ROM
  • Adhesive capsulitis
  • Tendon tears
31
Q

The likelihood of these complications increases with what?

A

age

724: Medical Lectures (42 decks)

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