Shoulder Flashcards
What are the muscles of the rotator cuff?
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
What is this a presentation of?
Adult over 40 years, shoulder weakness and pain, night pain affects sleep (unable to keep arm in comfortable position).
Tear in supraspinatus tendon or other rotator cuff muscles.
How is a suspected rotator cuff tear investigated?
US or MRI
How is a rotator cuff tear treated?
Refer to assess for open or arthroscopic surgical repair.
What are the three causes of impingement syndrome in the shoulder?
Tendon catches under acromion during abduction between 45-160 degrees.
- Supraspinatus tendinopathy
- Calcifying tendinopathy
- Acromioclavicular joint OA
What is this a presentation of?
Insidious onset shoulder pain, worsened by overhead activity, night pain.
Impingement syndrome of the shoulder
How is suspected impingement syndrome investigated?
X-ray and MRI
What is the treatment for supraspinatus tendinopathy causing impingement?
Physio, NSAIDs, refer if refractory for >6 months for arthroscopic subacromial decompression.
What is the treatment for calcifying tendinopathy causing impingement?
Physio, NSAIDs, steroid injections, rarely surgery.
What is the treatment for acromioclavicular joint OA?
Rest, NSAIDs, steroid injections.
What is this a presentation of?
Pain in shoulder worse at night (unable to lie on one side), must have restricted active and passive movements for at least 1 month, also impaired external rotation.
Adhesive capsulitis (frozen shoulder)
What are the phases of adhesive capsulitis?
- Painful phase - up to 1 year
- Frozen phase - 6-12 months
- Thawing phase - 1-3 years
How is suspected adhesive capsulitis investigated?
X-ray
What is the treatment for adhesive capsulitis?
Early physio, NSAIDs, steroid injections in early phase.
What is this a presentation of?
Pain in anterior shoulder, worsens with forced contractions of biceps (overhead lifting).
Biceps tendinopathy - inflammation of long head of biceps tendon
