Shoulder Conditions

Question 1

List the 4 rotator cuff muscles

Answer 1

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

Question 2

What happens in shoudler impingement?

Answer 2

Tendons of rotator cuff are compressed in the tight subacromial space

Question 3

What is the clinical sign of shoulder impingement?

Answer 3

Painful arc on abduction between 60-120 degrees

Question 4

Outline treatment for shoulder impingement

Answer 4

NSAIDs, analgesia
Physiotherapy
Subacromial steroid injection
Surgical decompression

Question 5

Give a classic history surrounding a rotator cuff tear

Answer 5

Older person (GREY HAIR) who suddenly jerks e.g. holding a rail when a bus suddenly stops

Question 6

Give another name for adhesive capsulitis affecting the shoulder

Answer 6

Frozen shoulder

Question 7

Define adhesive capsulitis

Answer 7

Progressive pain + stiffness in the shoulder that resolves after 18-24 mths due to contracture and thickening of glenohumeral joint

Question 8

What is the principle clinical sign of adhesive capsulitis?

Answer 8

Loss of external rotation + restricted other movements

Question 9

Which diseases are assoc. with frozen shoulder?

Answer 9

Diabetes
Hypercholesterolemia
Dupuytren’s disease

Question 10

What characterizes acute calcific tendonitis in the shoulder?

Answer 10

Acute severe shoulder pain

Calcium deposits on supraspinatus tendon

Question 11

Which shoulder dislocation is more common - anterior or posterior?

Answer 11

Anterior

Question 12

What is involved in Bankart repair for recurrent shoulder dislocations?

Answer 12

Stabilise shoulder by reattaching labrum and capsule to the anterior glenoid

Question 13

What is a common XR sign of posterior shoulder dislocation?

Answer 13

Lightbulb sign

Question 14

What are two common conditions causing multi-dislocation and shoulder instability? What clinical test is used to confirm it? How is it scored?

Answer 14

Ehler Danlos or Marfans
Sulcus sign
Beighton’s score

Question 15

How is shouldrr dislocation managed?

Answer 15

Analgesia IV
Oxygen
Sedation IV
Sling
Physio and gradual mobilisation
Reduction by manipualtion

Question 16

What imaging modalities are typically used in shoulder pathology affecting bone and muscle respectively?

Answer 16

XR (bone e.g. disclocation, adhesive capsulitis)
US (muscle e.g. impingement, RC tear)
MRI (muscle e.g. impingement, RC tear)

Question 17

Outline treatment for RC tear

Answer 17

Rest
Analgesia
Sling
Physio
Subacromial steroid injection
Surgical decompression

Question 18

Outline treatment for adhesive capsulitis

Answer 18

EXERCISE - WORK THROUGH PAIN
Analgesia
Physio
GH steroid injection
Manipulation/arthrolysis

Question 19

What is the main treatment for acute calcific tendonitis?

Answer 19

Steroid/ anaesthetic injection

Question 20

What are the risk factors for carpal tunnel syndrome?

Answer 20

MEDIAN NERVE
Young female
Pregnancy
Diabetes
Obesity
RA

Question 21

What are the risk factors for cubital tunnel syndrome?

Answer 21

ULNAR NERVE
Young male
Post-trauma
Direct pressure (cysts, tumours)
Arthritis

Question 22

What are the main clinical signs of carpal and cubital tunnel syndrome?

Answer 22

Pins and needles
Pain especially at night
Weakness
Thenar/ hypothenar wasting

Question 23

What are the main investigations for carpal and cubital tunnel syndrome?

Answer 23

NCS

EMG

Question 24

What are the main treatments for carpal and cubital tunnel syndrome?

Answer 24

Splintage (especially at night)
Physio
Steroid injection
Decompression