Shoulder Evaluation 2 Flashcards
Biceps tendon pathology:
presentation
- pain in anterior shoulder
- ttp over biceps tendon
- clicking/popping in anterior shoulder
- Popeye deformity (Tendon retraction)
Biceps tendon pathology:
treatment
- PT
- NSAIDs, injections
- surgery
Biceps tendon pathology:
Special tests
- Active compression test
- Bicipital load
- Speeds test
- Yergason’s test
**none of these exhibit good diagnostic accuracy
Crank test:
procedure
supine, shoulder flexed to 110˚
apply long axis pressure simultaneously with ER/IR
Crank test: interpretation
symptom reproduction and crepitus are positive tests for
labral derangement or other intra-articular pathology
Clunk test: procedure
With axial loading, glide the humerus A/P
Clunk test: symptom reproduction and crepitus are positive tests for
labral derangement or other intra-articular pathology
What is a SLAP lesion?
superior labral detachment from anterior to posterior
SLAP lesions: this tendon is often involved
LHB
SLAP lesions: often a tear between (clock)
10-2 o’clock
SLAP lesions: A tear between 10-2 o’clock significantly increases the strain on
anterior band of the IGHL
SLAP lesions: thought to occur by this mechanism
“peel back mechanism”
maximal shoulder ER thought to peel back the posterior labrum
SLAP lesions: most sensitive and specific tests for diagnosis
- MRI arthrogram
- contrast MRI
How many types of SLAP tears?
4
SLAP lesions: Type 1 characteristics
- isolated fraying of the labrum
- often degenerative in nature
- not concerning to physicians
SLAP lesions: Type II
characteristics
- detachment of superior labrum and LHB from the glenoid
- instability in the biceps-labral anchor
- often require surgery
SLAP lesions: Type III
characteristics
- bucket-handle tear
- biceps anchor still attached
SLAP lesions: Type IV
characteristics
bucket handle tear + bicep anchor detachment
SLAP lesions: most common type
Type II
Bankart lesions are found in (%) of shoulder dislocations
85%
Bankart lesion: occurs where on the clock?
2-6 o’clock on the R shoulder
6-10 o’clock on the L shoulder
These lesions commonly occur with Bankart lesions
Hill Sachs
Hill Sachs lesion is a compression fx of this aspect of the humeral head
posterolateral
Hill Sachs lesion: results from impact on the ___rim of the glenoid during anterior shoulder dislocation
anterior/inferior
Hill Sachs lesion: best viewed radiographically with this view
internal rotation or Stryker notch view
A reverse Hill Sachs is a compression fx of the ____ humeral head from a posterior dislocation
anterior/medial
