Shoulder & Elbow Problems Flashcards
In terms of shoulder problems what is the most likely injury for a 20yr old patient?
Fractures
Instability (i.e. dislocation)
In terms of shoulder problems what is the most likely injury for a 30 or 40 yr old patient?
Traumatic Rotator cuff tears
Capsulitis
In terms of shoulder problems what is the most likely injury for a 50 or 60 yr old patient?
Impingement
AC Joint degeneration
In terms of shoulder problems what is the most likely injury for a 75yr old patient?
Degenerative Rotator Cuff tears
Degenerative Joints
What are the types of Traumatic Shoulder Dislocation and their epidemiology?
90% are anterior
9% are posterior
1% are inferior
How can you treat a shoulder dislocation?
Manipulation
Immobilisation
Physiotherapy
Surgery
Define Subacromial Impingement?
Pain & dysfunction resulting from anything that decreases subacromial space or increases size of its contents
What could cause subacromial impingement?
Bony outgrowth under the acromion
Inflammation of supraspinatus tendon
Subacromial Bursitis
How do we treat a subacromial impingement?
Subacromial Steroid Injection followed by Physiotherapy.
If necessary surgery - Arthroscopic Subacromial Decompression
What is frozen shouldeR?
A chronic fibrosing condition defined by:
- Insidious progressive loss of active and passive shoulder ROM
- Pain
All in the absence of any known intrinsic disorder
How do we diagnose frozen shoulder?
Based on the clinical presentation of progressive pain followed by progressive stiffness when coupled with a normal X-ray and no other pathology.
How do we treat Frozen shoulder?
Early on (in the painful stage) can do steroid injection. Most cases present later in the stiff stage in which case surgery
How long does frozen shoulder last?
typically self-limiting but lasts around 18-24 months
Who gets a rotator cuff tear?
30s/40s get traumatic tears
elderly get degenerative tears
How do we treat a rotator cuff tear?
an Acute tear needs Early Surgery
A chronic degenerative tear only needs surgery if symptomatic
What types of arthritis affect the shoulder?
Osteoarthritis
Inflammatory Arthritis
Post-traumatic arthritis
List the common elbow problems?
Fractures/dislocations in the young
Tendinopathies in the middle aged
Degeneration in the elderly
Cubital tunnel syndrome can affect anyone
What are the most common elbow tendinopathies?
Golfer’s elbow - tendinopathy of the forearm flexors so pain at the medial epicondyle
Tennis Elbow - Tendinopathy of the forearm extensor so pain at the lateral epicondyle
Both are related to repetative strain from work or sport
How do we treat tennis and golfer’s Elbow?
ACtivity modification
PLatelet Rich Plasma (PRP) injection into the tendon followed by Physio
What happens in Cubital Tunnel Syndrome/
Compression of the ulnar nerve in the cubital fossa leads to loss of sensation in the little finger and medial half of ring finger
