Shoulder & Elbow Problems Flashcards
What is frozen shoulder?
- Also known as adhesive capsulitis (shoulder capsule become inflammed)
What is impingement syndrome?
- Middle age condition
- Any pathology which results in decreased volume of the subacromial space
- Very narrow anatomical area between acromion and supraspinatus muscle tendon is affected
- Presents with a painful arc between 30-120 degrees
What are rotator cuff tears?
- Traumatic or Degenerative
- Tendons of the rotator cuff muscles are torn
- Results in difficulty moving the shoulder joint
What is Golfers and Tennis Elbow?
- Both are classed as tendinopathies
- Golfers elbow originates from Medial epicondyle
- Tennis elbow originates from Lateral epicondyle
- Heal very well with biological treatment (take platelet rich plasma from horses and inject into humans)
What are the general principles of treatment for shoulder and elbow problems?
1 - Surgery
2 - Steroid Injections
3 - Physiotherapy
Which age group are most likely to suffer with fractures and instability of the shoulder and elbow?
Teens/20’s
What shoulder and elbow problems are the 30’s/40’s age group most likely to suffer with?
Rotator cuff & frozen shoulder
What shoulder and elbow problems are the 50’s and 60’s age group most likely to suffer with?
Subacromial Impingement
What shoulder and elbow problems are the 70’s+ age group most likely to suffer with?
Degenrative rotator cuff and joint problems
How are upper limb fractures most likely to occur and in which age group?
Young age group = High energy injuries
Older age group = Osteoporotic injuries
What are the most common type of traumatic shoulder dislocations?
Anterior
Why is the shoulder joint so commonly dislocated?
It is the most mobile joint in the body
What is the most common reason for 1st presentation of a shoulder dislocation?
Following a seizure - Epilepsy and shoulder dislocations are commonly seen together
What are the treatment options for traumatic shoulder dislocations?
1 - Manipulation
2 - Immobilisation
3 - Physiotherapy
4 - Surgery
Following a shoulder dislocation, how long should contact sports be avoided for?
6 months
Between which 2 structures is the subacromial space found?
Between:
- Lower border of Acromion
- Tendon of supraspinatus muscle
What is the name of the condition resulting from a decrease in the subacromial space?
Subacromial Impingement
What clinical symptom occurs as a result of subacromial impingement?
Painful arc
What is thought to cause subacromial impingement?
Inflammation of the tendon of the rotator cuff muscle - supraspinatus
What are the treatment options for subacromial impingement?
1 - Subacromial steroid injection (reduces inflammation)
2 - Physiotherapy
3 - Arthroscopic subacromial decompression (surgical option if first 2 options dont work)
How is frozen shoulder diagnosed?
Clinically
How does frozen shoulder appear on radiographs?
Normal
How is frozen shoulder treated on 1st presentation?
Steroid Injection
How is frozen shoulder treated on later presentations?
Surgically
What is the course of frozen shoulder?
First few months - Pain caused by freezing
Later - joint becomes much more immobile and stiff (frozen phase)
How are rotator cuff tears treated?
Surgery
Should chronic rotator cuff muscle tears always be treated surgically?
Only if symptomatic
What are the different types of shoulder arthritis?
Osteoarthritis
Inflammatory arthritis
Post-traumatic arthritis
What are the most common injuries of the elbow seen in young people?
Fractures & dislocations
What are the most common injuries of the elbow seen in the middle ages?
Tendinopathies
What are the most common problems of the elobow seen in the elderly?
Degenrative disease
What is another common problem of the elbow that can be seen at any age?
Cubital tunnel syndrome
What type of injuries are golfers and tennis elbow?
Tendonopathies
Where on the elbow does golfers elbow occur?
Medial aspect of elbow
Where on the elbow does tennis elbow occur?
Lateral aspect of elbow
Which muscle group of the forearm originates from the medial epicondyle?
Flexors of the anterior forearm
Which muscle group of the forearm originates from the lateral epicondyle?
Extensors of the posterior forearm
What is the best treatment option for tendonopathies?
Biologics
What is cubital tunnel syndrome?
- Compression of the ulnar nerve at the medial epicondyle
What are the symptoms of cubital tunnel syndrome?
Tingling or numbness in the small and ring finger
Pain in forearm and weakness in hand
What are the causes of frozen shoulder?
- Can be primary (idiopathic) or secondary (trauma)
