Shoulder Pain

Question 1

what are the referred causes of shoulder pain

Answer 1

cardiac, gallbladder, neck pathologies, polymyalgia

Question 2

where is subacromial pain often felt

Answer 2

in the deltoid region

Question 3

what causes popeye biceps

Answer 3

bunching of biceps after tendon rupture

Question 4

how do you distinguish frozen shoulder and arthritis

Answer 4

x ray

Question 5

how do you investigate rotator cuff tears

Answer 5

ultrasound

Question 6

what is the usually recovery time for rotator cuff problems

Answer 6

one year

Question 7

what are common causes of shoulder pain

Answer 7

rotator cuff problems (esp supraspinatus tendonitis) (35-65)
sub acromial bursitis 
acromioclavicular disease (trauma in young, arthritis in older)

less common:
frozen shoulder (more common in diabetes) (40-60)
OA/RA of shoulder
recurrent dislocation

Question 8

what is the differential for this patient:
53 female- left shoulder pain for several months, ache over left shoulder that travels down left arm. abduction limited to 90 degrees, internal and external rotation also limited

Answer 8

supraspinatus tendonitis 
subacromial bursitis 
frozen shoulder 
osteoarhtritis (AC joint, shoulder)
referred pain (neck, cardiac)

Question 9

what is the management for shoulder pain

Answer 9

explain
mobilise 
NSAIDs short term  
local injection (e.g. depo medrone with lignocaine- corticosteroid with analgesia)
physio 
time 

referral (rare if not resolving, instability or stuck)

Question 10

what does a 13 dexa scan of -3.8 suggest

Answer 10

osteoporosis

Question 11

what does a 13 dexa scan of -2.4 suggest

Answer 11

osteopenia