Shoulder & Elbow Problems

Question 1

What is frozen shoulder?

Answer 1

• Also known as adhesive capsulitis (shoulder capsule become inflammed)

Question 2

What is impingement syndrome?

Answer 2

• 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

Question 3

What are rotator cuff tears?

Answer 3

• Traumatic or Degenerative
• Tendons of the rotator cuff muscles are torn
• Results in difficulty moving the shoulder joint

Question 4

What is Golfers and Tennis Elbow?

Answer 4

• 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)

Question 5

What are the general principles of treatment for shoulder and elbow problems?

Answer 5

1 - Surgery

2 - Steroid Injections

3 - Physiotherapy

Question 6

Which age group are most likely to suffer with fractures and instability of the shoulder and elbow?

Answer 6

Teens/20’s

Question 7

What shoulder and elbow problems are the 30’s/40’s age group most likely to suffer with?

Answer 7

Rotator cuff & frozen shoulder

Question 8

What shoulder and elbow problems are the 50’s and 60’s age group most likely to suffer with?

Answer 8

Subacromial Impingement

Question 9

What shoulder and elbow problems are the 70’s+ age group most likely to suffer with?

Answer 9

Degenrative rotator cuff and joint problems

Question 10

How are upper limb fractures most likely to occur and in which age group?

Answer 10

Young age group = High energy injuries

Older age group = Osteoporotic injuries

Question 11

What are the most common type of traumatic shoulder dislocations?

Answer 11

Anterior

Question 12

Why is the shoulder joint so commonly dislocated?

Answer 12

It is the most mobile joint in the body

Question 13

What is the most common reason for 1st presentation of a shoulder dislocation?

Answer 13

Following a seizure - Epilepsy and shoulder dislocations are commonly seen together

Question 14

What are the treatment options for traumatic shoulder dislocations?

Answer 14

1 - Manipulation

2 - Immobilisation

3 - Physiotherapy

4 - Surgery

Question 15

Following a shoulder dislocation, how long should contact sports be avoided for?

Answer 15

6 months

Question 16

Between which 2 structures is the subacromial space found?

Answer 16

Between:

• Lower border of Acromion
• Tendon of supraspinatus muscle

Question 17

What is the name of the condition resulting from a decrease in the subacromial space?

Answer 17

Subacromial Impingement

Question 18

What clinical symptom occurs as a result of subacromial impingement?

Answer 18

Painful arc

Question 19

What is thought to cause subacromial impingement?

Answer 19

Inflammation of the tendon of the rotator cuff muscle - supraspinatus

Question 20

What are the treatment options for subacromial impingement?

Answer 20

1 - Subacromial steroid injection (reduces inflammation)

2 - Physiotherapy

3 - Arthroscopic subacromial decompression (surgical option if first 2 options dont work)

Question 21

How is frozen shoulder diagnosed?

Answer 21

Clinically

Question 22

How does frozen shoulder appear on radiographs?

Answer 22

Normal

Question 23

How is frozen shoulder treated on 1st presentation?

Answer 23

Steroid Injection

Question 24

How is frozen shoulder treated on later presentations?

Answer 24

Surgically

Question 25

What is the course of frozen shoulder?

Answer 25

**First few months** - Pain caused by freezing **Later** - joint becomes much more immobile and stiff (frozen phase)

Question 26

How are rotator cuff tears treated?

Answer 26

Surgery

Question 27

Should chronic rotator cuff muscle tears always be treated surgically?

Answer 27

Only if symptomatic

Question 28

What are the different types of shoulder arthritis?

Answer 28

Osteoarthritis Inflammatory arthritis Post-traumatic arthritis

Question 29

What are the most common injuries of the elbow seen in young people?

Answer 29

Fractures & dislocations

Question 30

What are the most common injuries of the elbow seen in the middle ages?

Answer 30

Tendinopathies

Question 31

What are the most common problems of the elobow seen in the elderly?

Answer 31

Degenrative disease

Question 32

What is another common problem of the elbow that can be seen at any age?

Answer 32

Cubital tunnel syndrome

Question 33

What type of injuries are golfers and tennis elbow?

Answer 33

Tendonopathies

Question 34

Where on the elbow does golfers elbow occur?

Answer 34

Medial aspect of elbow

Question 35

Where on the elbow does tennis elbow occur?

Answer 35

Lateral aspect of elbow

Question 36

Which muscle group of the forearm originates from the medial epicondyle?

Answer 36

Flexors of the anterior forearm

Question 37

Which muscle group of the forearm originates from the lateral epicondyle?

Answer 37

Extensors of the posterior forearm

Question 38

What is the best treatment option for tendonopathies?

Answer 38

Biologics

Question 39

What is cubital tunnel syndrome?

Answer 39

- Compression of the ulnar nerve at the medial epicondyle

Question 40

What are the symptoms of cubital tunnel syndrome?

Answer 40

Tingling or numbness in the small and ring finger Pain in forearm and weakness in hand

Question 41

What are the causes of frozen shoulder?

Answer 41

- Can be primary (idiopathic) or secondary (trauma)