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MSK > Shoulder and Elbow Problems > Flashcards

Shoulder and Elbow Problems Flashcards

1
Q

What are the most common shoulder problems in teenagers-20s?

A

Fractures and instability

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2
Q

What are the most common shoulder problems in 30s-40s?

A

Rotator cuff injuries and capsulitis

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3
Q

What are the most common shoulder problems in 50s-60s?

A

Impingement and AC joint issues

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4
Q

What are the most common shoulder problems in 70s+?

A

Degenerative rotator cuff and joint

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5
Q

What are the two associations with upper limb fractures?

A

Young with high energy injuries

Elderly osteoporotic fractures

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6
Q

What is the most commonly dislocated joint? And why?

A

Shoulder because the humeral head is substantially larger than the glenoid fossa

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7
Q

In which way does the shoulder tend to dislocate?

A

Anterior (anterior-inferior)

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8
Q

What causes most shoulder dislocations?

A

Falling on an outstretched arm

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9
Q

What are the symptoms of shoulder dislocation?

A

Pain, inability to move shoulder

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10
Q

What are the signs of shoulder dislocation?

A

Palpable dent (empty glenoid fossa), squared off shoulder

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11
Q

Does a shoulder dislocation require imaging?

A

Yes to rule out fractures

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12
Q

How do you manage a shoulder dislocation?

A

Muscle relaxants, analgesia, closed reduction, immobilisation, physio

If complicated (e.g. Bankart lesion) - open reduction and internal fixation may be req.

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13
Q

What are complications of a shoulder dislocation?

A

Axillary nerve damage, rotator cuff injury

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14
Q

What is a Bankart lesion?

A

Injury of the anterior glenoid labrum of the shoulder due to anterior shoulder dislocation

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15
Q

What is a subacromial impingement?

A

Pain and dysfunction from any pathology increasing the volume of the subacromial space/size of its contents

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16
Q

What commonly causes subacromial impingement?

A

Tendon tissue, esp. supraspinatous or soft tissue that is trapped in the joint

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17
Q

What symptoms are commonly caused by subacromial impingement?

A

Pain on movement (esp. overhead activities), nocturnal pain (esp. when lying on shoulder), painful arc

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18
Q

What is painful arc?

A

Pain related restriction of movement and strength with abduction of arm between 60 and 120 degrees)

19
Q

How do you treat subacromial impingement?

A

Subacromial steroid injection, physiotherapy, arthroscopic subacromial depression

20
Q

What is adhesive capsulitis?

A

Aka frozen shoulder

Inflammation and fibrosis of the joint capsule leading to contracture of the joint

21
Q

How do you diagnose adhesive capsulitis?

A

Clinically

22
Q

What symptoms are typical of adhesive capsulitis?

A

Severe restriction and limitation of both active and passive RoM in all plates (esp. external rotation), dull shoulder pain

23
Q

What will you find on XRay with adhesive capsulitis?

A

Nothing

24
Q

What is the management of adhesive capsulitis?

A

Physiotherapy and NSAIDs
If early presentation, steroid injections can help bring down swelling

Late presentation - surgery

25
Q

How long does it usually taken for adhesive capsulitis to go away?

A

1.5-2 years

26
Q

What are the two types of rotator cuff injury?

A

Traumatic - acute injury, in athlete, acute severe pain and loss of strength

Degenerative - older adults, chronic pain, loss of strength less pronounced

27
Q

In rotator cuff injury what tendon appears to be most commonly affected?

A

Supraspinatus

28
Q

What are the signs of rotator cuff injury?

A

Superior displacement of the humeral head on XRay

29
Q

How do you manage rotator cuff injuries?

A

Acute tear - early surgery

Chronic degenerative - symptomatic - surgery, but treatment mostly conservative

30
Q

What are the types of arthritis that can affect the shoulder?

A

OA, inflammatory arthritis, post-traumatic arthritis

31
Q

What is the most common way to dislocate your elbow?

A

Fall on outstretched hand

32
Q

What is the most common type of elbow dislocation?

A

Posterior

33
Q

What are the signs and symptoms of an elbow dislocation?

A 
Pain, swelling, inability to flex/extend 
Ekbow deformity (olecranon more prominent posteriorly), limb length discrepancy)
34
Q

What imaging should you do for elbow dislocation?

A

XRay - confirm dislocation, rule out fractures

35
Q

How do you manage elbow dislocation?

A

Simple - analgesia, closed reduction, immobilisation

More complex - open reduction, internal fixation

36
Q

What causes insertional tendinopathies?

A

Repetitive strain and subsequent poor healing

37
Q

What is tennis elbow?

A

Overuse injury of hand and finger extensors that originate in the lateral humeral epicondyle (i.e. from repetitive/excessive pronation/supination and extension of wrist)

38
Q

What are the clinical features of tennis elbow?

A

Pain and tenderness over lateral epicondyle and extensor muscles, thickening of tendons

39
Q

What is golfer’s elbow?

A

Overload injury of the hand and finger flexor tendons that originate in the medial humeral epicondyle(from repeated wrist flexion and pronation)

40
Q

What are the clinical features of Golfer’s elbow?

A

Pain over medial epicondyle and along flexor muscles, thickening of tendons

41
Q

What is cubital tunnel syndrome?

A

Compression of the ulnar nerve at the elbow

42
Q

What is the aetiology of cubital tunnel syndrome?

A

Leaning on elbow/prolonged elbow flexion, athletic activities

43
Q

What are the clinical features of cubital tunnel syndrome?

A

Sensory loss over hypothenar eminence and medial 1 1/2 fingers
+ve tinel test

44
Q

What is tinel test?

A

Paraesthesiae reproduced in ulnar portion of hand by tapping medial epicondyle of humerus

MSK (27 decks)

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