Shoulder Diff dx

Question 1

Subacromial impingement

Answer 1

Anterior/lateral shoulder pain, pain with shoulder ER
Special tests: Neers, Hawkinson Kennedy, Yocum, Empty can
Painful arc 60-120°

Question 2

Labrum tear

Answer 2

Trauma!
Deep anterior shoulder pain
Clicking, clunking, pain with throwing
Special test: O’Brien, bicep loading, anterior slide, compression rotation test

Question 3

Frozen shoulder (adhesive capsulitis)
40-60y/o

Answer 3

Stiffness, decreased ROM, pain due to thickening of shoulder capsule
Capsular pattern: ER, ABD, IR
Insidious onset: diabetes, thyroid, trauma

Question 4

Frozen shoulder/adhesive capsulitis stages:

Answer 4

Stage 1 (0 to 3mths): mild sx, achy @rest, pain at night. Loss of ER.
Stage 2 aka freezing (3-9mths): loss of motions in all planes, PAIN
Stage 3 aka frozen (9-15mths): pain only with movements, atrophy of shoulder muscles, scap moves more than humerus
Stage 4 aka thawing (15-24mths): pain decreases, but still stiff. Slow recovery.

Question 5

Anterior shoulder instability

Answer 5

Most common
Mechanism of inj: abduction, ER - common with sports
Brings humeral head anterior
Special tests: load and shift, anterior apprehension
Avoid : chest press

Question 6

Posterior shoulder instability

Answer 6

Rare
Mech of inj: flexion, IR, Adduction
Special test: post apprehension, Kim test, jerk test
Avoid: push ups

Question 7

Inferior instability

Answer 7

Very rare, CVA injury
Special test: sulcus sign
Avoid shoulder shrugs

Question 8

Rotator cuff

Answer 8

Older than 40
Loss of strength

Question 9

SLAP

Answer 9

Clicking, clunk, joint locking
Trauma

Question 11

AC joint instability

Answer 11

Painful arc 170-180
Step deformity