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J MSK > Shoulder conditions > Flashcards

Shoulder conditions Flashcards

1
Q

type of shoulder condition in <30 year old

A

instability (sports injury)

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2
Q

type of shoulder condition in middle aged people (2)

A

frozen shoulder

rotator cuff injury

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3
Q

type of shoulder condition in elderly people (2)

A

glenohumeral OA

cuff tear

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4
Q

general management of shoulder conditions (3)

A

short term NSAID
steroid injections
physio

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5
Q

another name for impingement syndrome

A

painful arc

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6
Q

what are compressed in impingement syndrome that cause the pain

A

rotator cuff tendons

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7
Q

which degree of movement is there pain in impingement syndrome

A

60-120 abduction

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8
Q

compression of rotator cuff tendons in the subacromial space between 60-120 degrees of abduction

A

painful arc (impingement syndrome)

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9
Q

which age group gets painful arc (impingement syndrome)

A

30-40s

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10
Q

aetiology of painful arc (3)

A

sports injury
manual worker
tendon degeneration

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11
Q

which rotator cuff muscle is typically affected in painful arc (impingement syndrome)

A

supraspinatus

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12
Q

presentation of impingement syndrome (3)

A 
painful arc (60-120 degrees abduction)
shoulder weakness 
pain radiating to deltoid
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13
Q

treatment from GP for impingement syndrome (3)

A

analgesia/NSAID
physio for 3 months
3 steroid injections

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14
Q

what are the steroid injections used in the shoulder

A

depo medrone with lignocaine

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15
Q

impingement syndrome

after 6 months if the 3 injections are ineffective what do you do

A

surgery for decompression

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16
Q

investigations for impingement syndrome (to rule out other causes)

A

xray - calcification, eyebrow sign ultrasound

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17
Q

which age group get rotator cuff tears

A

> 40 year olds

grey hairs = cuff tears

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18
Q

most common rotator cuff muscle for rotator cuff tears

A

supraspinatus

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19
Q

pathophysiology of rotator cuff tear

A

degenerative and a jerk

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20
Q

presentation of rotator cuff tear

A

sudden jerk of arm resulting in immediate pain and weakness

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21
Q

treatment of rotator cuff tear (3)

A

NSAID
physio
injections

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22
Q

when might you do a surgery for rotator cuff tear

A

if young

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23
Q

recurrence rate of rotator cuff tears

A

40% reoccur after 1 year

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24
Q

complication of rotator cuff tear

A

osteoarthritis

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25
Q

inflammation of glenohumeral ligaments causing them to thicken and contract

A

frozen shoulder

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26
Q

which age/gender get frozen shoulders

A

40-60s
females

(think mum)

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27
Q

which chronic condition predisposes you to getting a frozen shoulder

A

diabetes

28
Q

what are the 3 phases of a frozen shoulder (how it presents)

A

severe pain for 6 months (FREEZING)
pain settles but limited movement (FROZEN)
movement returns within 2 years (THAWING)

29
Q

which movement is lost in frozen shoulder

A

external rotation

30
Q

investigation (necessary for diagnosis) of frozen shoulder

A

xray - must be normal for diagnosis (to exclude OA and locked posterior dislocation)

31
Q

treatment of frozen shoulder

A

physio - first line!
NSAID/analgesia
injections if painful >6 months

32
Q

how long should it take for full resolution of a frozen shoulder (self limiting conditions)

A

18-24 months

33
Q

calcium deposits in the supraspinatus tendon seen on xray

A

acute calcific tendonitis

34
Q

most common tendon for shoulder pathology

A

supraspinatus

35
Q

presentation of acute calcific tendonitis

A

severe acute onset pain

36
Q

treatment of acute calcific tendonitis

A

steroid injection for pain

local anaesthetic for pain

37
Q

how is acute calcific tendonitis diagnosed

A

xray

38
Q

how is acute calcific tendonitis cured

A

self limiting

calcification gets reabsorbed

39
Q

most common type of shoulder dislocation

A

anterior

40
Q

what is shoulder subluxation

A

partial dislocation

41
Q

aetiology of posterior shoulder dislocation

A

seizure

ligamentous laxity conditions (ehlers-danlos syndrome, marfans)

42
Q

aetiology of anterior shoulder dislocation

A

sports injury

43
Q

cause of badge patch numbness in a shoulder dislocation

A

axillary nerve damage

44
Q

shoulder dislocation presentation caused by trauma (3)

A

pain
loss of symmetry
sometimes badge patch numbness

45
Q

investigations for shoulder dislocation caused by trauma (2)

A

xray

neurovascular assessment - pulses and nerves before and after surgery (to make sure you dont cause damage!)

46
Q

treatment of shoulder dislocation caused by trauma (4)

A

calm patient - analgesia, sedation, O2
relocation/manipulation by closed reduction
sling for 2-4 weeks
physio for strengthening

47
Q

treatment of recurrent shoulder dislocations from trauma

A

surgery for stabilisation

48
Q

if <20 and have a shoulder dislocation are they more or less likely to have a re-dislocation than someone >30

A

more

80% re-dislocation for <20s
20% re-dislocation for >20s

49
Q

aetiology of atraumatic shoulder dislocations

A

ligamentous laxity conditions eg ehlers-danlos, marfans

50
Q

presentation of atraumatic shoulder dislocation

A

not painful

51
Q

what would you see on xray in atraumatic shoulder dislocation

A

‘light bulb sign’ on xray

bc humerus is twisted so looks symmetrical front on

52
Q

treatment of atraumatic shoulder dislocation

A

surgery

physio strengthening

53
Q

what is a bankart lesion

when does it occur

A

when labrum (fibrocartilage) becomes injured and detaches from glenoid fossa

after shoulder dislocation

54
Q

what is a hill sachs injury

when does it occur

A

fracture of posterior humeral head

after shoulder dislocation

55
Q

shoulder dislocation but pain doesnt settle

A

rotator cuff tear

56
Q

treatment of acromioclavicular joint dislocation (collar bone to shoulder)

A

sling and physio

surgery - if >100% dislocation, young athletes, chronic pain

57
Q

which age group get glenohumeral osteoarthritis

A

> 60s

58
Q

presentation of shoulder OA (4)

A

gradual onset
pain at night
limited movement
crepitus on examination

59
Q

what would you see on xray for someone with shoulder OA

A 
LOSS; 
loss of joint space 
osteophytes 
subchondral cysts 
sclerosis
60
Q

treatment of shoulder OA (4)

A

analgesia
physio
steroid injections
surgery - shoulder replacement, a few different options

61
Q

biceps tendonitis definition

where

A

inflammation of long head of biceps

in the bicipital groove of humerus

62
Q

presentation of biceps tendonitis (3)

A

popeye sign - bunched up triceps
anterior shoulder pain worse on shoulder/elbow flexion
bruising

63
Q

treatment of biceps tendonitis (2)

A

rest and physio

surgery (neurovascular risk)

64
Q

complication of biceps tendonitis

A

tendon rupture

65
Q

who gets biceps tendonitis (4)

A

athletes that through things
swimmers
gymnasts
heaving lifting occupations

66
Q

how does biceps tendonitis come about

A

friction between biceps tendon and bicipital groove on humerus = inflammation of tendon

J MSK (30 decks)

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