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MSK > Shoulder & Elbow Problems > Flashcards

Shoulder & Elbow Problems Flashcards

1
Q

In terms of shoulder problems what is the most likely injury for a 20yr old patient?

A

Fractures

Instability (i.e. dislocation)

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2
Q

In terms of shoulder problems what is the most likely injury for a 30 or 40 yr old patient?

A

Traumatic Rotator cuff tears

Capsulitis

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3
Q

In terms of shoulder problems what is the most likely injury for a 50 or 60 yr old patient?

A

Impingement

AC Joint degeneration

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4
Q

In terms of shoulder problems what is the most likely injury for a 75yr old patient?

A

Degenerative Rotator Cuff tears

Degenerative Joints

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5
Q

What are the types of Traumatic Shoulder Dislocation and their epidemiology?

A

90% are anterior
9% are posterior
1% are inferior

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6
Q

How can you treat a shoulder dislocation?

A

Manipulation
Immobilisation
Physiotherapy
Surgery

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7
Q

Define Subacromial Impingement?

A

Pain & dysfunction resulting from anything that decreases subacromial space or increases size of its contents

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8
Q

What could cause subacromial impingement?

A
  • Bony outgrowth under the acromion
  • Inflammation of supraspinatus tendon
  • Subacromial Bursitis
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9
Q

How do we treat a subacromial impingement?

A
  • Subacromial Steroid Injection
  • NSAIDS
  • Physiotherapy.
  • If necessary surgery - Arthroscopic Subacromial Decompression
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10
Q

What is frozen shouldeR?

A

A chronic fibrosing condition defined by:
- Insidious progressive loss of active and passive shoulder ROM
- Pain
-May be worse at night
All in the absence of any known intrinsic disorder

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11
Q

How do we diagnose frozen shoulder?

A
  • Clinical : progressive pain + stiffness

- Normal radiograph

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12
Q

How do we treat Frozen shoulder?

A

For early presentation:
o Hydrodilatation- contrast medium, cortisone and local anaestetic are injected into the joint capsule
o Or early physiotherapy and NSAIDS/ steroid injections

Later on: surgery under anaestetic
o Manipulation
o Arthroscopic arthrolysis

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13
Q

Who gets a rotator cuff tear?

A

Mainly over 40s

  • 30s/40s get traumatic tears
  • Elderly get degenerative tears
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14
Q

How do we treat a rotator cuff tear?

A
  • Acute= early surgery
  • Chronic = only surgery if symptomatic
  • Depends on size, age and how long they have had it for

Superior capsular reconstruction

  • Surgery used for massive, irreparable rotator cuffs
  • Cadaveric skin graft used to reconstruct capsule- not tendon
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15
Q

What types of arthritis affect the shoulder?

A

Osteoarthritis
Inflammatory Arthritis
Post-traumatic arthritis

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16
Q

List the common elbow problems?

A

Fractures/dislocations in the young
Tendinopathies in the middle aged
Degeneration in the elderly
Cubital tunnel syndrome can affect anyone

17
Q

What are the most common elbow tendinopathies?

A

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

18
Q

How do we treat tennis and golfer’s Elbow?

A
  • ACtivity modification
  • PLatelet Rich Plasma (PRP) injection into the tendon
  • Physio
  • NO STEROID INJECTION
19
Q

How would you manage a traumatic shoulder dislocation?

A
  • Clinical observation
  • Check nerve function and pulses
  • X-Ray
  • Analgesia e.g. intra-articular local anaestetic, opiod, ENTONOX
20
Q

What is the common presentation of a traumatic shoulder dislocation?

A
  • Often bulge on head of humerus
  • Flattening of the deltoid
  • Anterior: Common in contact sports where the shoulder has been fixed into external rotation, extension and abduction
  • Posterior: usually presents with reduced external rotation
21
Q

Classic presentation of a frozen shoulder?

A
  • Initially pain (up to 1 year)
  • Followed by stiffness: pain usually settles but range of movement still decreased (6-12 months)
  • Followed by thawing: Slowly regains RoM (1-3 years)
22
Q

What is the presentation of a rotator cuff tear?

A
  • Weakness

- Pain

23
Q

What imaging would you do for a rotator cuff tear?

A
  • MRI

- US

24
Q

What is cubital tunnel syndrome

A

Constriction of the Ulnar nerve due to OA/RA narrowing of the ulnar groove so less room for Ulnar nerve when it passes behind the medial epicondyle. This can lead to nerve neuropathy.

25
Q

Presentation for CTS

A
  • Reduced sensation: especially in little finger, medial half of ring finger
  • Weakness of hand/ clumsiness
26
Q

Investigation for CTS

A
  • Nerve conduction studies
27
Q

Treatment for CTS

A
  • Surgical decompression

MSK (40 decks)

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