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musculoskeletal > Shoulder Conditions > Flashcards

Shoulder Conditions Flashcards

1
Q

who usually presents with shoulder instability

A

young, sporty, teenage-30

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2
Q

aetiology of traumatic shoulder instability

A

instability following an anterior dislocation

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3
Q

what cause atraumatic shoulder instability

A

generalised laxity (ehlers-danlos, marfans) can have pain from recurrent multidirectional subluxation/dislocation

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4
Q

clinical signs of shoulder instability

A

abnormal shoulder contour
muscle wasting, spasm
good ROM
scapular winging

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5
Q

give some special tests you can do in examination of shoulder instability

A

sulcus sign, draw tests, apprehension and relocation tests

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6
Q

investigations for shoulder instability

A

radiographs: AP and garth
MRI arthrogram

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7
Q

management of traumatic shoulder instability

A

Bankart repair

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8
Q

name some injuries associated with shoulder instability

A

fracture of humeral head
fracture of glenoid
rotator cuff tear in older patients

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9
Q

what is glenohumeral OA

A

OA of the shoulder

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10
Q

who usually presents with OA of the shoulder

A

> 60 yrs

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11
Q

symptoms of OA of the shoulder

A

gradual onset, intermittent exacerbations
pain at rest and at night
stiffness, functional difficulties

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12
Q

clinical signs of OA of the shoulder

A

asymmetry, wasting
limitation of external rotation
global movement restriction
pain through ROM

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13
Q

investigation for OA of the shoulder

A

radiographs show: joint space narrowing, subchondral sclerosis, subchondral cysts, osteophyte formation

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14
Q

conservative management of OA of the shoulder

A

analgesia, physio, steroid injection

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15
Q

surgical management of OA of the shoulder

A

arthroplasty

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16
Q

what is another name of adhesive capsulitis

A

frozen shoulder

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17
Q

what is adhesive capsulitis

A

inflammation and fibrosis of the joint capsule leading to contracture of the shoulder joint

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18
Q

who usually presents with adhesive capsulitis

A

females 40-50

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19
Q

what is adhesive capsulitis associated with

A

diabetes, hypercholesterolaemia, dupuytrens

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20
Q

pathophysiology of adhesive capsulitis

A

contracture and thickening of coraco-humeral ligament, rotator interval, axillary fold → decrease in joint volume

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21
Q

symptoms of adhesive capsulitis

A

gradual severe pain: rest, at night, anterior pain
stiffness

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22
Q

clinical sign of adhesive capsulitis

A

global restriction in ROM, especially in external rotation

23
Q

investigation of adhesive capsulitis

A

clinical diagnosis

24
Q

conservative management of adhesive capsulitis

A

physio + analgesia
intra-articular steroid injection

25
Q

who usually presents with a rotator cuff tear

A

grey hair = cuff tear
50-60 yrs

26
Q

what are the 2 main causes of a rotator cuff tear

A

degeneration
FOOSH, sudden jerk

27
Q

what is most commonly involved in a rotator cuff tear

A

supraspinatus

28
Q

symptoms of a rotator cuff tear

A

pain in the front of the shoulder that radiates down the arm
associated weakness

29
Q

clinical signs of a rotator cuff tear

A

wasting of supraspinatus
tenderness in subdeltoid region

30
Q

management of a rotator cuff tear

A

rest, physio
injections

31
Q

what is the most common joint dislocation

A

shoulder dislocation

32
Q

why is the shoulder the most common joint dislocation

A

the head of the humerus is substantially larger than the glenoid fossa

33
Q

who usually presents with a shoulder dislocation

A

younger patients, sporty, mostly traumatic

34
Q

what is the most common direction of shoulder dislocation

A

anterior

35
Q

cause of an anterior shoulder dislocation

A

fall with shoulder in external rotation

36
Q

what is at risk with an anterior shoulder dislocation

A

axillary artery

37
Q

what are the 2 main causes of a posterior shoulder dislocation

A
  • fall with shoulder in anterior location
  • direct blow to anterior shoulder
38
Q

clinical sign of an anterior shoulder dislocation

A

humeral head anterior to the glenoid

39
Q

clinical sign of a posterior shoulder dislocation

A

humeral head posterior to the glenoid

40
Q

what are posterior shoulder dislocations often associated with

A

seizures

41
Q

how do patients present with an inferior shoulder dislocation

A

arm above their head

42
Q

clinical presentation of a shoulder dislocation

A
  • Severe shoulder pain
  • Inability to move the shoulder
  • Empty glenoid fossa (dent) may be visible
43
Q

investigation of a shoulder dislocation

A

x-ray: AP and garth

44
Q

complication of a shoulder dislocation

A

recurrent instability risk

45
Q

who usually presents with shoulder impingement

A

patients <25

46
Q

what is shoulder impingement

A

inflammation and irritation of the rotator cuff tendons as they pass through the subacromial space

47
Q

what is rotator cuff tendonitis

A

Repeated impingement results in inflammation or damage of the rotator cuff tendons

48
Q

what is subacromial bursitis

A

calcification of the tendon following rotator cuff tendonitis

49
Q

clinical presentation of shoulder impingement

A

progressive pain in the anterior superior shoulder
radiates to the deltoid and upper arm
difficulty sleeping, reaching overhead and lifting

50
Q

examination finding that could be a sign of shoulder impingement

A

painful arc

51
Q

first line imaging of shoulder impingement

A

x-ray: AP and garth

52
Q

conservative management of shoulder impingement

A

rest, NSAIDs, physio, steroid injections

53
Q

when is surgery indicated for shoulder impingement and what does it involve

A

> 6 months of no change
subacromial decompression

musculoskeletal (30 decks)

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