Shoulder Flashcards
what is the most common shoulder pathology in the young
shoulder dislocation/instability
what are the most common shoulder pathologies in the middle age
impingement
frozen shoulder
traumatic cuff tear
calcific tendonitis
what is frozen shoulder also known as
adhesive capsulitis
describe Look Feel Move for frozen shoulder
look: mild diffuse atrophy of the deltoid and supraspinatus
Feel: diffuse tenderness over the glenohumeral joint
Move: painful and limited ROM, particularly shoulder abduction and ER
what two movements are especially difficult in frozen shoulder
abduction and external rotation
what is the management of frozen shoulder
conservative: physical therapy, NSAIDs and intraarticular steroid injections
operative: MUA, arthroscopic lysis of adhesions, rotator cuff release, posterior capsular release
what is the Ix of choice for frozen shoulder
Normally just a simple Xray but can do a distention arthrogram
what causes shoulder impingement
tendons of the rotator cuff muscle become irritated and inflamed as they pass through the subacromial space beneath the acromion
how does shoulder impingement present
ROM - pretty normal until range where it becomes uncomfortable.
Can manage everything until it reaches a certain range/level, then above that the patients cannot complete tasks, especially above shoulder height
describe the management of shoulder impingement
conservative: physical therapy, oral anti-inflammatories, subacromial injections
operative: subacromial decompression with acromioplasty
give the four rotator cuff muscles
supraspinatus
infraspinatus
teres minus
subscapularis
what a chronic degenerative rotator cuff tear what muscles are commonly involved
Supraspinatus
teres minor
infraspinatus
what are the clinical features of a rotator cuff tear
hx of trauma
painless loss of function
what investigations should you do in a rotator cuff tear
ultrasound +/- MRI
what nerve is at risk during shoulder dislocation
axillary nerve
