Shoulder Dz - Duerr Flashcards
Medial Shoulder Instability (MSI)
- Unknown etiology, repetitive microtrauma/overstretching?
- Usually occurs in ____ ____: agility, flyball, hunting, etc
- Mild-moderate ____ lameness, decreased _____, change in gait
- Dx: painful shoulder ______, mild OA or normal rads, increased _____ angle
- Confirmation of Dx:
- _____ and _____
adult athletes
chronic
performance
aBduction
aBductioin
Arthroscopy and MRI
Simple overview of MSI
- Measure _____ angle
- R/O other pathologies
- Tx:
- Mild/moderate = _____
- Severe = ____
- If no improvement, arthroscopy and prosthetic ligament reconstruction
- Prognosis? ____
Abduction
Rehab/hobbles/ESWT
Sx
Good :)
Biceps/Supraspinatus
- Usually occurs in ____, med/lg breed ____ dogs
- Hx of _____ lameness (NWB with partial acute avulsion), ______ with exercise
- DDX:
- ED/DJD - rads +/- CT for ____-onset
- OA, proximal humerus ____ - rads
- Neuro - check reflexes, CPs, anisocoria
Middle-aged
Athletic
Progressive
Exacerbated
adult-onset
OSA
Shoulder - Diagnostics
1st:
- Exam:
* abduction angle = MSI/mm atrophy
* mm pain = myopathy? = further dx
* infrasp gait
- Rads
- OCD
- Arthritis
- mm calcification
- caudal glenoid fragment
- U/S
- Biceps
- Infraspinatus
- Supraspinatus
- Teres minor
What are the next steps if treatment doesn’t improve?
MRI & Arthroscopy
CT
- OCD, mm calcification
Jt fluid analysis
- septic arthritis
Biceps/Supraspinatus Workup
___ -> ___ -> ___ = Tentative diagnosis & targeted tx (rehab)
if no significant improvement…
____ -> ____ = Definitive Dx & release/excision
PE
Rads
US
Scope
MRI
Shoulder injuries/lameness are frequently due to ____ problems which can be missed on _____ but _____ is a useful dx for these pathologies
OCD is generally treated with ____ and the prognosis is ______ (shoulder only!)
Whenever suspecting a shoulder lameness one should consider _____ problems as a ddx
Muscle problems
Rads
US
Sx
Great!
ED, Neuro, etc
Biceps Tendinopathy
Dx tests: ____
Tx: ____
Comment: ______
Palpation, US, MRI, Arthroscopy
Frequently start with rehab; consider sx for severe cases
Biceps tenotomy for partial avulsions or severe cases
Supraspinatus Tendinopathy
Dx tests: ____
Tx: ____
Comment: ______
Palpation, US, MRI
Frequently start with rehab; consider sx for severe cases
Supraspinatus myectomy is available for severe/refractory cases or if biceps impingement
MSI
Dx tests: ____
Tx: ____
Comment: ______
Abduction angle (>40 degree)
Rehab vs Sx reconstruction
Medial glenohumeral (collateral) ligament and subscapularis may be affected; less severe injuries can be treated with hobbles, etc
OCD
Dx tests: ____
Tx: ____
Comment: ______
Rads, CT
Flap Removal
Excellent prognosis with Sx!
OCD
- usually ___ & ___breeds (juveniles)
- lameness is _____ (but can be ______
- lameness may ____ & ____ or even disappear
- Causes? ____, _____ (high Ca, high calorie/protein)
- Ddx: ___ & ____
large and giant
unilateral
bilateral
wax and wane
genetics, nutrition
ED and panosteitis
