Shoulder and elbow disorders

Question 1

A 50 year old male painter and decorator presents with a 3 month history of pain in his right shoulder
Name three differentials

Answer 1

Impingement syndrome
Osteoarthritis of the gleno-humeral joint
Osteoarthritis of the acromio-clavicular joint
Referred pain from the neck
Frozen Shoulder
Rotator cuff tear

Question 2

What are the key features in the history for Impingement syndrome?

Answer 2

Pain associated with or aggravated by overhead activity
Pain perceived over lateral aspect of the upper arm
Pain when lying on the shoulder in bed

Question 3

What are the key features in the history for Frozen Shoulder?

Answer 3

Stiffness and or pain
Particular difficulty with internal and external rotation (getting hand behind head or behind back)
History of trauma in secondary frozen shoulder
Often a history of diabetes in primary frozen shoulder

Question 4

Describe 2 clinical tests for impingement syndrome

Answer 4

1. Neer’s Impingement Sign- pain on passive forward flexion within an arc from 60 to 120 degrees
2. Painful Arc- pain on passive abduction within an arc from 60 to 120 degrees

Question 5

Name the rotator cuff muscles and their function

Answer 5

Supraspinatus – initiates abduction
Subscapularis – internal rotation
Infraspinatus and Teres Minor – external rotation

Question 6

Two imaging for rotator cuff injury

Answer 6

Ultrasound
MRI

Question 7

What movement of the arm occurs due to insertion in medial epicondyle?

Answer 7

flexion

Question 8

What about lateral?

Answer 8

extension

Question 9

What is lateral epicodylitis also known as?

Answer 9

tennis elbow

Question 10

What is medial epicodylitis also known as?

Answer 10

golfer’s elbow