shoulder and elbow injuries Flashcards
what type of joint is the shoulder joint ?
ball and socket type
what are the muscles of the shoulder associated with abduction ?
initiation of abduction - supraspinatus 0-15
15-90 deltoid
what are the muscles associated with external rotation of the shoulder ?
infraspinatus
teres minor
what are the muscles associated with internal rotation of the shoulder joint ?
subscapularis
what are the muscles of the rotator cuff ?
supraspinatus
infraspinatus
teres minor
subscapularis
what is the most common cause of shoulder pain ?
subacromial impingement
what are the causes of subacromial impingement ?
subacromial bursitis
acromion morphology
all causing rotator cuff tendon inflammation
what is the clinical picture of subacromial impingement ?
painful shoulder
painful abduction
what are the findings on examination associated with subacromial impingement ?
tenderness over AC joint
painful arc
what are the special tests for subacromial impingement ?
scarf test ( integrity of AC joint )
hawkins-kennedy test
what is the hawkins kennedy test ?
internal rotation of the shoulder whilst the elbow is at 90 degrees
if it is painful this is positive for shoulder impingement
what is the gold standard for the diagnosis of subacromial impingement ?
MRI
what is the treatment for subacromial impingement ?
conservative - NSAIDS , injections , physiotherapy
surgery if conservative fails - subacromial decompression
what is the clinical picture of rotator cuff tears ?
shoulder pain
inability to initiate abduction
what are the special tests done for rotator cuff tears ?
jobe’s test / empty can test - supraspinatus
resisted ER test - infraspinatus
Gerber lift-off test - subscapularis
what are the characteristic findings associated with end stage rotator cuff arthropathy ?
rotator cuff insufficiency
glenohumeral cartilage destruction
superior migration of the humeral head
subchondral osteoporosis
what is the clinical picture of rotator cuff arthropathy ?
shoulder pain ( with activity and at night )
shoulder weakness
shoulder stiffness
what are the findings on examination of rotator cuff arthropathy ?
muscle atrophy
reduced range of motion
what surgery cannot be performed in rotator cuff arthropathy ?
total shoulder arthroplasty cannot be used
what are the shoulder inflammatory conditions ?
bicipital tendinitis
frozen shoulder
what are the examination findings in bicipital tendinitis ?
tenderness over long head of bicep tendon
anterior shoulder pain
what is frozen shoulder ?
a condition characterized by functional loss of active and passive range of motion
what is the primary vcause of frozen sshoulder ?
adhesive capsulitis
what are the associated conditions with frozen shoulder ?
diabetes
thyroid disorders
diabetic w masek ketfo ?
frozen shoulder
what is the clinical picture of frozen shoulder ?
non specific shoulder pain
limitation of active range of motion that affects ADL
muscle wasting
external rotation more evidently affected
if nonoperative management fails in frozen shoulder what is the next best step in management ?
manipulation under anesthesia
what is the mmost common direction of dislocatioin oof the shoulder ?
anterior
when do we see posterior dislocation of the shoulder ?
electric shocks orr seizures
what is the picture of anterior shoulder dislocation ?
arm is externally rotated
loss of shoulder contour
empty glenoid
where is the affection in tennis elbow ?
lateral epicondylosis
what is the presentation of tennis elbow ?
pain with resisted wrist extension
tenderness over the lateral epicondyle
where is the affection in golfers elbow ?
medial epicondylosis
what is the presentation with golfers elbow ?
pain with wrist flexion and pronation
what is the clinical picture of olecranon bursitis ?
localised swelling at the tip of the elbow
what is cubital tunnel syndrome ?
compression neuropathy of the ulnar nerve at the elbow
what are the associated conditions of cubital tunnel syndrome ?
medial epicondylosis
what is the clinical picture of cubital tunnel syndrome ?
paraesthesia off medial 1 and half fingers
partial claw hand
intrinsic muscle weakness
