Shoulder and elbow problems

Question 1

what is the commonest cause of shoulder problems in young patients < 30?

Answer 1

fractures

instability

Question 2

what are the commonest causes of shoulder problems in 30s and 40s?

Answer 2

rotator cuff and capsulitis

Question 3

what are the commonest causes of shoulder problems in 50s and 60s?

Answer 3

impingement and acromioclavicular joint

Question 4

what are the commonest causes of shoulder problems in 70+ ?

Answer 4

degenerative rotator cuff and joint

Question 5

what is the epidemiology of upper limb fractures?

Answer 5

young patients - high energy injuries

elderly osteoporotic injuries

Question 6

what is the commonest site of a shoulder dislocation?

Answer 6

anterior (90% of patients)

Question 7

what is a bankart tear? and what is the consequence of this?

Answer 7

tearing of the glenoid labrum due to an anterior shoulder dislocation
this makes a person prone to recurrent dislocations

Question 8

what is the treatment for a shoulder dislocation?

Answer 8

manipulation
immobilisation
physiotherapy
surgery

Question 9

what is subachromial impingement?

Answer 9

pain and dysfunction resulting from any pathology with decreases the volume of the subacromial space or increases the size of its contents

Question 10

in what age category is subacromial impingement most common?

Answer 10

30s,40s,50s

Question 11

what is the treatment for subacromial impingement?

Answer 11

subacromial steroid injection
physiotherapy
arthroscopic subacromial decompression

Question 12

what is a frozen shoulder?

Answer 12

the joints capsule becomes thickened and tightened
the shoulder becomes very painful and stiff
also known as adhesive capsulitis

Question 13

what is the natural history of a frozen shoulder?

Answer 13

shoulder is very painful and range of movement becomes starts to become limited
the pain starts to subside but the shoulder becomes very stiff
the range of movement starts to improve (about 18-24 months)

Question 14

what is the treatment for a frozen shoulder?

Answer 14

hydrodilatation if early stage

late stage = surgery

Question 15

what is the aetiology of a rotator cuff tear?

Answer 15

either traumatic or degenerative

Question 16

what are the different types of shoulder arthritis?

Answer 16

osteoarthritis
inflammatory arthritis
post traumatic arthritis

Question 17

what are the different elbow conditions in different age categories?

Answer 17

the young: fractures and dislocations
middle age: tendinopathies
elderly: degenerative disease
cubital tunnel syndrome at any age

Question 18

what is golfers elbow and tennis elbow?

Answer 18

golfers elbow is pain on the inside of the elbow

tennis elbow is pain on the outside of the elbow

Question 19

what is cubital tunnel syndrome?

Answer 19

damage to the ulnar nerve
damage typically occurs at the cuttable fossa
presents with pain and paraesthesia

Question 20

what clinical sign would you find in a patient that would make you think subacromial impingement?

Answer 20

cannot abduct their arm - painful

Question 21

what would mimic a frozen shoulder and how would you differentiate between them?

Answer 21

dislocation and arthritis with global restriction in the patients arm movements
the X-ray would be normal in a frozen shoulder as it is a soft tissue problem

Question 22

what is the treatment for a rotator cuff tear?

Answer 22

acute tear = surgery
chronic = surgery only if symptomatic
- superior capsular reconstruction if irreparable rotator cuff (uses cadaveric skin to reconstruct the joint capsule)

Question 23

what are the 2 main surgeries for shoulder arthritis?

Answer 23

standard shoulder replacement (requires functioning rotator cuff)
reversed shoulder replacement (maximise function of deltoid)

Question 24

give an example of a tendonopathy of the elbow.

Answer 24

golfers and tennis elbows

Question 25

what is the treatment for tendinopathies of the elbow?

Answer 25

platelet rich plasma