Shoulder and Elbow Problems Flashcards
What age are rotator cuff problems and capsulitis seen in?
30s and 40s
What ages are impingement and AC joint problems seen in?
50s and 60s
What ages are degenerative rotator cuff and joint seen in?
70s +
What is the most mobile joint of the body?
The shoulder
Most dislocated positions of the shoulder
Anterior 90%
Posterior 9%
Inferior 1%
How does a posterior shoulder dislocation usually occur?
Fitting in sleep
What % are you likely to have a recurrent shoulder dislocation if you are in your teens and why is this?
90-95%
Due to labrum tear
Treatment of traumatic shoulder dislocation
Manipulation Immobilisation Physio Surgery - if risk of shoulder to dislocate again -> 2 dislocations is one too many
After a treatment of shoulder dislocation, how many months should they be out of contact sport?
6 months
How does the shoulder dislocation surgery prevent it from dislocating again?
can anchor labrum onto the glenoid to create a bumper to stop it dislocating again
Definition of subacromial impingement
Pain and dysfunction resulting from any pathology which decreases the volume of the subacromial space or increases the size of the contents i.e. swelling
Presentation of subacromial impingement
Painful arch Pain in abduction - initial part pain free - as move up gets more and more painful - as near to the top then the pain may subside no pain in general
Treatment of subacromial impingement
subacromial steroid injection
physio
arthroscopic subacromial decompression
Pathology of frozen shoulder
adhesive capsulitis - inflammation of the joint lining
Types of frozen shoulder
Primary - unknown cause
Secondary
- where the shoulder stiffens up due to e.g. periods of immobilisation or injury
Presentation of frozen shoulder
Freezing phase = PAIN - very acute (people present to A and E) - wakes people at night - very agonising - miserable life Frozen stage = as pain subsides - pain stopping - starts to get stiff - global restriction of all movements Thawing phase - ROM starts to improve
The 3 stages of frozen shoulder
- freezing phase
- frozen phase
- thawing phase
How long can frozen shoulder last from the start (the pain) to the finish (the thaw)?
2 years
Investigations of frozen shoulder
examination
- no difference between active and passive movements
radiograph (normal)
Treatment of frozen shoulder
Early presentation = inject steroid
later presentation = surgery
Types of rotator cuff tear
Traumatic
Degenerative
If pain of a shoulder is not settling with physio, what is the condition suspected as until proven otherwise?
Rotator cuff tear
Treatment of rotator cuff tea
Acute tears = early surgery
Chronic degenerative tears = surgery if symptomatic
What age are tendinopathies of the elbow seen in?
middle age
Symptoms of cubital tunnel syndrome
numb little finger and one half of ring finger
Pathology of cubital tunnel syndrome
Compression of the ulna nerve as it passes round the back of the medial epicondyle
What is golfers elbow?
Area of pain on the inside of the forearm
Flexor muscles that are attached to the medial epicondyle
What is tennis elbow?
Area of pain on the outside of forearm
Extensor muscles that are attached to the lateral epicondyle
What causes elbow tendinopathies?
Same repetitive activities e.g.
- golf/tennis
- manual labourers
- fish markets
Lesions associated with anterior dislocation of the shoulder
Bankart lesion
Hills-Sach defect
Features of an acromioclavicular dislocation
Loss of shoulder contour
Prominent clavicle
