Shoulder complaint

Question 1

referral from cervical or thoracic spine facet or trigger points

Answer 1

shoulder pain

Question 2

radicular pain from cervical nerve root compression

Answer 2

shoulder pain

Question 3

peripheral nerve and brachial plexus entrapments

Answer 3

shoulder pain

Question 4

referral from visceral sources such as diaphragm, gallbladder, lungs or heart

Answer 4

shoulder pain

Question 5

shoulder pain from trauma could be:

Answer 5

fracture, dislocation, tendon rupture

Question 6

shoulder pain from overuse could be:

Answer 6

tendinitis, capsular sprain, bursitis

Question 7

shoulder pain from arthritides could be:

Answer 7

osteoarthritis, RA

Question 8

other sources of shoulder pain

Answer 8

tumor or infection

Question 9

anterior shoulder pain from trauma could be:

Answer 9

fracture, dislocation, subacromial bursitis, capsular sprain, labrum tear

Question 10

anterior shoulder pain not from trauma could be:

Answer 10

general impingement syndrome, biceps tendinitis, subacromial bursitis, subluxation

Question 11

lateral shoulder pain from trauma could be:

Answer 11

contusion, supraspinatus rupture, referral from cervical spine or brachial plexus injury

Question 12

lateral shoulder pain not from trauma could be:

Answer 12

impingement syndrome, deltoid strain, supraspinatus tear or rupture, referral from cervical spine

Question 13

superior shoulder pain from trauma could be:

Answer 13

AC joint separation, distal clavicle fracture

Question 14

superior shoulder pain not from trauma could be:

Answer 14

OA of AC joint, osteolysis of distal clavicle

Question 15

posterior shoulder pain from trauma could be:

Answer 15

scapular fracture, posterior dislocation

Question 16

posterior shoulder pain not from trauma could be:

Answer 16

posterior impingement, infraspinatus or teres minor strain, posterior deltoid strain, triceps strain, suprascapular nerve entrapment

Question 17

blow to the anterior shoulder could cause

Answer 17

dislocation, subluxation, contusion

Question 18

fall on top of shoulder could cause

Answer 18

AC joint separation, distal clavicle fracture

Question 19

FOOSH could cause

Answer 19

AC separation, clavicle fracture, posterior dislocation glenoid labrum, rotator cuff tear

Question 20

arm forced into external rotation and horizontal abduction with shoulder flexed to 90 degrees could cause

Answer 20

anterior dislocation, glenoid labrum tear

Question 21

sudden contraction of the arm could cause

Answer 21

subluxation, brachical plexus traction injury

Question 22

sudden pain with weightlifting could cause

Answer 22

muscle/tendon rupture, labrum tear

Question 23

if pt has pain, no history of trauma, all ranges of motion are painful:

Answer 23

acute subacromial bursitis or early adhesive capsulitis

Question 24

pt reports lateral/anterior shoulder pain with overhead activities or exhibit a painful arc

Answer 24

subacromial impingement, tendinitis, or bursitis

Question 25

pt reports instability, apprehension, painful activities when shoulder is abducted and externally rotated

Answer 25

shoulder instability or labral tear if clicking

Question 26

decreased ROM and pain with resistance

Answer 26

rotator cuff

Question 27

pt reports pain and weakness with muscle loading and night pain with age greater than 60

Answer 27

rotator cuff

Question 28

pt reports poorly located shoulder pain with aggravation by movement and relieved by rest with age greater than 45

Answer 28

adhesive capsulitis

Question 29

most commonly overhead activities over time produce

Answer 29

impingement

Question 30

orthos for impingement syndrome

Answer 30

Neers, Hawkins-Kennedy

Question 31

subacromial impingement pain is here

Answer 31

anterior joint

Question 32

infraspinatus/teres minor impingement pain is here

Answer 32

posterior

Question 33

if painful arc between 60 and 120 degrees then:

Answer 33

impingement syndrome

Question 34

Hawkin's test and Neer's test are for:

Answer 34

rotator cuff impingement

Question 35

normal subacromial space on xray is

Answer 35

9-10 mm

Question 36

xray shows elevation of humerus, erosion of inferior aspect of the acromion process, sclerosis, osteophytes, cystic changes

Answer 36

rotator cuff arthropathy with shoulder impingement

Question 37

history of shoulder dislocation, pain or weakness when arm is placed in overhead position or apprehension position

Answer 37

traumatic instabiity

Question 38

shoulder stability evaluated with these tests

Answer 38

load and shift test, apprehension test, relocation test

Question 39

rotator cuff tear most frequently involves

Answer 39

supraspinatus

Question 40

shoulder pain may be more noticeable at night or at rest, dull or achy pain, weakness or decreased ability to move joint, difficulty raising or lowering the arm, painful arc sign, weakness in external rotation

Answer 40

rotator cuff

Question 41

empty can test shows

Answer 41

supraspinatus weakness

Question 42

lift off test shows

Answer 42

subscapularis weakness

Question 43

tests for rotator cuff

Answer 43

empty can test, infraspinatus muscle test, palpation

Question 44

modality of choice for rotator cuff tears

Answer 44

MRI

Question 45

on MRI, increased signal intensity in the region of the critical zone

Answer 45

rotator cuff tear

Question 46

test to check for sprain/strain of supraspinatus

Answer 46

empty can test

Question 47

test to check for sprain/strain of subscapularis

Answer 47

lift off test

Question 48

test to check for sprian/strain of infraspinatus/teres minor

Answer 48

lag sign

Question 49

test to check for sprain/strain of biceps

Answer 49

speed's test

Question 50

acute onset of pain that may or may not be traumatic, stiffness is progressive, pt usually over 40, abduction and external rotation decreased first then internal rotation decreased

Answer 50

adhesive capsulitis

Question 51

all ROM are affected with acute stage (especially end range forward flexion), tenderness found anterior to AC joint on passive extension of the shoulder

Answer 51

subdeltoid bursitis

Question 52

on xray shows calcification around head of humerus

Answer 52

HADD

Question 53

history of popping, clicking, or catching; instability testing may be positive; may have painful sticking in movement

Answer 53

glenoid labrum tear (SLAP)

Question 54

tests for SLAP lesion

Answer 54

crank test and O'Brien's

Question 55

on MRI, when looking at a straight lateral view of the shoulder this tear is from 10-2 (like on a clock)

Answer 55

SLAP

Question 56

on MRI, when looking at a straight lateral view of the shoulder this tear is from 3-6 (like on a clock)

Answer 56

Bankart

Question 57

on xray the normal width of AC joint

Answer 57

less than 5 mm

Question 58

on xray the normal distance between coracoid and clavicle

Answer 58

11-13 mm

Question 59

AC joint separation typically occurs from

Answer 59

FOOSH injury

Question 60

on xray if the clavicle is typically less than 50% displaced it means this grade of tear

Answer 60

grade 2 tear

Question 61

usually due to indirect force on arm while in abducted and externally rotated position; may occur during FOOSH

Answer 61

anterior shoulder dislocation

Question 62

xray shows osseous fragment adjacent to the inferior aspect of the glenoid fossa

Answer 62

bankart lesion

Question 63

xray shows sclerosis, mottled density, collapse, subchondral fracture, and crescent sign associated with humeral head

Answer 63

AVN