Shoulder Flashcards
What is the presentation of a rotator cuff tear?
This is commonly an insidious presentation with trauma being less common
Shoulder weakness and pain
Supraspinatus wasting and weakness of abduction initiation
How is a rotator cuff tear investigated?
Ultrasound is cheaper and quicker
MRI allows quantification of muscle wasting that is a useful prognostic indicator
How is a rotator cuff tear managed?
Incomplete tears can be managed conservatively or surgically if symptoms persist
Complete require prompt referral for assessment
What does a painful arc 60-120 degrees suggest?
Supraspinatus tendinopathy
Also has positive impingement tests
What is the treatment of suraspinatus tendinopathy?
Conservative and physio 0 active movement
Subacrominal bursa steroid injection
If symptoms >6months then refer for arthroscopic subacromial decompression
What is the presentation of a frozen shoulder?
This is adhesive capsulitis and normally is idiopathic
Phases:
-Painful phase (up to 1 year) - active and passive movement reduced
-Frozen phase - pain settles but shoulder remains frozen - 6-12 months
-Thawing phase - the shoulder regains movement 1-3 years
What is the treatment of frozen shoulder?
Physiotherapy early and NSAIDs
Corticosteroid injection in early phase
Can surgically release with manipulation under anesthetic
What are the clinical features of shoulder OA? How is it treated?
It is painful and restricted movements in all directions
Treat with physio, steroid injections and surgery
What specific test should be done to examine a tear in supraspinatus?
Upside down can test, flexion against resistance
What examination should be done to examine infraspinatus tear?
Should externally rotate against resistance
What joint does the scarf test diagnose pain in?
Acromioclavicular joint
What are the risk factors for a frozen shoulder?
Female
Middle age
hypothyroid
Diabetic
What is a bankart lesion and how is it treated?
This is an injury of the lubrum, treated surgically
