Shoulder And Elbow Disorders

Question 1

What is sub acromial impingement

Answer 1

Inflammation and irritation of shoulder tendon (rotator cuff tendons) as they pass through subacromial space

Type of tendinitis / rotator cuff injuries

Question 2

Sub acromial impingement presentation

Answer 2

Painful abduction
Starts after recent over the head activity (activity related injury)
Painful arc of range of motion

Question 3

Most common type of rotator cuff injury and test for it

Answer 3

Supraspinatus tendon

Drop arm test and empty can test (pain)

Question 4

Treatment for tendinitis / rotator cuff injuries

Answer 4

Intra articulate steroid injection and physio

Question 5

Both types of shoulder dislocation and when each happens

Answer 5

Anterior - usually after FOOSH (98% of shoulder dislocations

Posterior - forced internal rotation or direct blow to front of shoulder - CAN ALSO HAPPEN WITH ELECTROCUTION / SEIZURES

Question 6

Presentation and examination for anterior shoulder dislocation

Answer 6

• guards arm at side of body
• FOOSH injury
• check axilaary nerve as can be damaged (by checking sensation of deltoid)
• also check rotator cuff after reduction
• check neurovascular status before and after dislocation reduction

Question 7

Posterior shoulder dislocation treatment

Answer 7

Reduction

Question 8

What is adhesive capsulitis

Answer 8

Frozen shoulder - complications or shoulder injury - surgery

Slow progressive loss of PASSIVE (on examination) and active ROM of shoulder joint caused by chronic fibrosis

Question 9

Adhesive capsulitis presentation

Answer 9

Women
40-70 yrs
Recent shoulder injury or shoulder surgery
Shoulder pain that may be worse at night
Frozen shoulder - stiff - even on active and passive movement
Diabetes
Thyroid disease

Frozen shoulder progressively

Question 10

Clinical findings for adhesive capsulitis

Answer 10

Sever stiffness in shoukder even on passive examination

Coracoid pain test positive

Rule out fracture and posterior shoulder dislocation with x ray

Question 11

Adhesive capsulitis treatment

Answer 11

1st physio and NSAIDs

2nd IA steroid injection

Question 12

What is Tennis elbow

Answer 12

Lateral epicondylitis - swelling of tendons

Question 13

What are the causes of tennis elbow (lateral epicondylitis

Answer 13

Over use of extensor muscles attached epicondyle- typing, screwdriver, tennis backhand, direct injury

Question 14

Sx and Tx of tennis elbow

Answer 14

Point tenderness of lateral aspect of elbow

Rest, physio and NSAIDs

Question 15

What is golfers elbow and what causes it

Answer 15

Medial epicondylitis

Over use of flexor/pronation muscles attached to epicondyle

Question 16

Sx and Tx of golfers elbow

Answer 16

Poitntenderness of medial aspect of elbow

Rest, physio and NSAIDs

Question 17

What is “pulled elbow” and its presentation

Answer 17

Dislocation of elbow - nursemaids elbow

Common in children under 5 - usually when swinging chikdren by hands

Presentation - no swelling, not using affected arm and distress on only elbow movement, tenderness ONLY on movement

Question 18

Diagnosis and treatment of pulled elbow

Answer 18

Diagnosis with X ray

Treat - reduce and mobilise

Question 19

Which injury causes wasting of thenar eminence + which nerve is damaged

Answer 19

Carpal tunnel syndrome

Medial nerve

Question 20

Which injury causes loss of sensation of deltoid + which nerve is damaged

Answer 20

Anterior shoulder dislocation

Axillary nerve

Question 21

Which injury causes wrist drop and which nerve is affected

Answer 21

Neck of humerus fracture

Radial nerve

Question 22

Which injury causes claw hand and which nerve is affected

Answer 22

Medial epicondyle fracture

Ulnar nerve