shoulder pain Flashcards
majority of osteoarthritis of shoulder occurs where
acromioclavicular joint, particularly with repetitive overhead activities or a hx of heavy weight liftning
differential for shoulder pain
rotator cuff disorders (tendinopathy, partial tears, complete tears)
adhesive capsulitis
shoulder joint arthritis
shoulder instability
typical features of rotator cuff disorders
often there’s repetitive overhead shoulder activities
partial tears most common >40
complete tears most common >60
pain localized to deltoid
pain worse w overhead activities and at night
pain and or weakness of rotator cuff muscles on manual testing
positive impingement tests
adhesive capsulitis-typical features
pain w/ progressive loss of both active and passive range of motion
assoc w diabetes, females, middle decades of life
shoulder joint arthritis-typical features
AC joint arthritis:
- all ages w/ hx of repetitive overhead lifting or heavy weight training
- pain localized to superior aspect of shoulder (AC joint)
- pain worse at night and w cross body mvmts
- tenderness at AC join on exam as well as with cross body adduction
glenohumeral arthritis: rare
shoulder instability-typical features
- most common in young pts and athletes
- often hx of acute shoulder injury or fall w/ dislocation or sensation of pop or shift in shoulder
- dislocation/subluxation most commonly occurs with arm in abducted and externally rotated position
- positive apprehension test
in under 40 yo, what are more likely causes for shoulder pain?
instability
rotator cuff tendinopathy
key elements in hx for common shoulder disorders
see p459 age gender pain location hx of repetitive overuse hx of trauma limited passive range of motion weakness night pain numbness, tingling, radiating pain past elbow diabetes or thyroid disorders occupation sports participation
red flags for shoulder pain
fever, chills, redness, IV drug use, immune deficiency
anorexia, weight loss
persistent shoulder pain in children
Hawkins test tests
imgpingement of supraspinatus
empty can test tests
rotator cuff injury, particuparly supraspinatus
drop arm test significance
if cannot lower in a controlled fashion, high ly specific for a large rotator cuff tear
cross body adduction test helps with diagnosing
AC joint osteoarthritis
chronic anterior shoulder instability can be diagnosed with what test
apprehension test
