Shoulder Pain Flashcards
What can cause pain to be referred to the shoulder?
- Cervical spine
- Diaphragmatic or subdiaphragmatic peritoneum
- Cervical spondylosis
What are the causes of shoulder girdle pain in relation to anatomy?
Shoulder cuff
- Degeneration
- Tendon rupture
- Calcific tendonitis
Subacromial bursa
- Calcific bursitis
- Polyarthritis
Capsule
- Adhesive capsulitis
Head of humerus
- Tumour
- Osteonecrosis
- Fracture/dislocation
Joint
- Genohumeral, sternoclavicular (inflammatory arthritis, OA, dislocation, infection)
- Acromioclavicular (subluxation, OA)
What are the non-traumatic conditions affecting the shoulder?
- Rotator cuff syndromes
- Impingement syndromes (rotator cuff and subacromial bursa)
- Adhesive capsulitis (frozen shoulder)
- Calcific tendonitis
- Bicipital tendonitis
- Inflammatory arthritis
- Polymyalgia rheumatica
What are the traumatic conditions affecting the shoulder?
Rotator cuff tear
- Glenohumeral dislocation
- Acromioclavicular dislocation
- Fracture of clavicle
- Fracture of the head or neck of humerus
What are the special test and what do they test for?
Empty can test
- Supraspinatus
Lift off test
- Subscapularis
Scarf test
- ACJ pathology
Hawkins Kennedy test
- Supraspinatus impingement
What are the rotator cuff muscles and what do they do?
SITS
Supraspinatus
o Abducts arm
Infraspinatus
o External rotation
Teres minor
o External rotation
Subscapularis
o Medial rotation of arm
What is subacrominal impingement?
Humeral head moves too close to the acromion causing pain
What is calcific tendonitis?
Calcium build-up in rotator cuff tendon
What is a rotator cuff tear?
o Injury to tendons of the rotator cuff muscles
Most commonly affects supraspinatus
What is rotator cuff arthropathy?
Rotator cuff tear and arthritis
What are the clinical features of a rotator cuff tear?
Should pain on active movement
o Abduction = supraspinatus
o External rotation = infraspinatus, teres minor
o Internal rotation = subscapularis
Weakness
What is the management of rotator cuff injuries?
- Rest
- Analgesia
- Physiotherapy
- Corticosteroid injections into subacromial space
Surgery for tears
What is supraspinatus tendinopathy?
Inflammation of supraspinatus tendon
Usually due to impingement at the point where it passes between the humeral head and acromion
What is adhesive capsulitis/frozen shoulder?
Inflammation and fibrosis in the glenohumeral joint capsule can lead to adhesions.
Adhesions bind the capsule and cause it to tighten around the joint, restricting movement.
What conditions are associated with adhesive capsulitis/frozen shoulder?
DM
Thyroid
