Shoulder and elbow problems Flashcards
What shoulder problems occur in the teens
fractures and instability
What shoulder problems occur in 30-40s
rotator cuff and capsulitis
What shoulder problems most commonly occur in 50s and 60s
Impingement (tendon of rotator cuff is pinched) and AC joint
What shoulder problem occurs in 70>
Degenerative rotator cuff and joint
Why is the shoulder joint instable
Because it’s mobility is so good
What is the treatment of dislocation of the shoulder
Manipulating the joint back into place
immobilisation
Physiotherapy
Surgery
subacromial impingement
degeneration in the acromio-clavicular joint produces osteophytes – as the arm abducts, the greater tuberosity impinges on the rotator cuffs – the bursa which separates the two becomes inflamed so there is less space and the acromion-clavicular ligament also becomes impinged
What is the bigliani definition of impingement
Pain and dysfunction caused by pathology which decreases the volume of the subacromial space or causes an increase in the size of the contents
What is the treatment of subacromial impengement
Subacromial steroid injection
physiotherapy
Arthroscopic subacromial decompression - coracoid ligament was removed and the space improved
What is frozen shoulder (adhesive capsulitis)
Shoulder is painful and stiff
What is the treatment of frozen shoulder if it presents early
steroid injections are most common treatment
hydrodilatation - injecting fluid into the joint to stretch out the joint capsule
What is the treatment of frozen shoulder if it presents late
surgery
What is the diagnostic pattern of frozen shoulder
Initial painful shoulder - pain eases but the shoulder becomes stiff - then the stiffness begins to thaw and return to normal
What are the two types of causes of rotator cuff tear
trauma
degenerative
How is rotator cuff tear diagnosed
Clinical - diagnosed on exam
Ultrasound or MRI can also be used for diagnosis
What is the key different thing between frozen shoulder and subacromial impingement
Subacromial impingement is stiff and painful during abduction while frozen shoulder is stiff in every movement of the shoulder joint
What is the treatment of acute rotator cuff tear
early surgery
What is the treatment of chronic degenerative tear
surgery if symptomatic
What is an option for massive, irreparable rotator cuff tears
superior capsular reconstruction
What elbow issues occur in the young
Fracture and dislocation
What elbow issues occur in middle age
Tendinopathies
What elbow issues occur in the elderly
degenerative
What issues occur in the elbow joint at all ages
Cubital tunnel syndrome at any age
Where does golfers elbow pain occur
inside of forearm (medial side) - flexors attach to this
Where does tennis elbow pain occur
outside of the forearm (lateral side) - extensors attach to this
