SHOULDER AND ELBOW - common problems Flashcards
What is main shoulder problem in teens/20s
Fractures and instability
Often anterior pain
What is main shoulder problem in 30-40s
Rotator cuff & capsulitis
What is main shoulder problem in 50-60s
Impingement and AC joint
- Abduction of arm in deltoid region – impingement
What is main shoulder problem in >70s
Degenerative rotator cuff and joint
- Leads to sublaxation of shoulder and arthertis between humeral head and scapula
What directions can the shoulder dislocate
It can dislocate in 3 directions:
- Anterior 90%,
- posterior 9% (fits or electric shocks)
- inferior 1%
What is treatment for shoulder dislocation
Manipulation - usually under sedation - Hippocratic method - Cocker method Immobilisation Physiotherapy Surgery
Are younger people more or less likely to get further shoulder dislocation after a shoulder dislocation
more likely
Are older people more or less likely to get further shoulder dislocation after a shoulder dislocation
Older people with dislocation get very stiff so are less likely to get re-dislocation
What is a Subacromial impingment
Pain and dysfunction resulting from any pathology which decreases the volume of the subacromial space or increases the size of the contents
What age group commonly get Subacromial impingment
Common in people in middle years of life
What is treatment for Subacromial impingment
Subacromial Steroid injection
Physiotherapy
Arthroscopic subacromial decompression
What is frozen shoulder
The shoulder capsule becomes tight and stiff bands of tissue called adhesions develop
What is frozen shoulder also known as
Adhesive Capsulitis
What are the categories of frozen shoulder
Primary (no known cause)
Secondary (usually post trauma)
Why is frozen shoulder an issue with older people
This is an issue with older people as the shoulder stiffens very quickly. The joint needs to get moving as fast as
What is treatment for frozen shoulder
If it presents early then can try HYDRODILATION Can also try: - Steroid injection - Physiotherapy - Surgery (if persistent)
What are two types of rotator cuff tear
Traumatic
Degenerative
What investigations are used in rotator cuff tear
Ultrasound
MRI scan
Why is ultrasound used in rotator cuff tear
Gives detail on whether complete or partial tear
Why is MRI used in rotator cuff tear
Gives more details about muscle
What is treatment for acute rotator cuff tear
early surgery
What is treatment for chronic rotator cuff tear
Surgery if symptomatic
Is shoulder arthritis common
Much less common than in hip or knee
What is main elbow problem in young
Fractures & dislocations
What is main elbow problem in middle age
Tendinopathies
What is main elbow problem in elderly
Degenerative disease
When do cubital tunnel syndrome occur
Any age
What is hydrodilation
Injecting a fluid into the joint space which expands the space breaking up scar tissue and loosening the joint
What are risk factors for frozen shoulder
Diabetes
Hypo/hyper thyroidism
Parkinsons
