Shoulder Pain Flashcards
Painful arc test
Tests for subacromial impingement and rotator cuff tendon injury
Highest positive LR of all rotator cuff maneuvers
Lowest negative LR of all rotator cuff maneuvers
Positive: shoulder pain from 60-120 deg
VINDICATE for shoulder
Vascular Inflammatory Neoplastic Degenerative/Deficiency Idiopathic/Intoxication Congenital Autoimmune/Allergic Traumatic Endocrine
Clavicle fx are most common in what population?
Kids and young adults
Proximal humerus fx are most common in what population?
Elderly
Scapular fx are most associated with what?
Blunt trauma
What direction are glenohumeral dislocations most common?
Anterior
Impingement syndrome
Sx resulting from compression of rotator cuff tendons and subacromial bursa
Most rotator cuff injuries occur primarily in the ____ tendon
Supraspinatous
___ are the most common cause of shoulder pain in primary care
Rotator cuff injuries
Top causes of chronic shoulder pain
Rotator cuff disorders
Adhesive capsulitis
Shoulder instability
Shoulder arthritis
Top causes of life threatening shoulder pain
Septic arthritis
Referred pain
What is the best diagnostic tool for septic arthritis?
Aspiration of synovial fluid
What is the most sensitive indicator of joint disease?
Evaluation of range of motion
Apprehension test
Pt seated or supine, shoulder abducted to 90 deg
Stabilize shoulder with 1 hand, force arm into external rotation with other hand
+: pt apprehensive of repeat dislocation, glenohumeral instability
Sulcus sign
Grab pt’s elbow and apply inferior traction
+: indentation appears in an area beneath the acromion, indicates glenohumeral instability
Yergason’s test
Pt supinates and externally rotates against physician resistance
+: pain or tendon subluxation out of the groove, unstable bicipital
Speed’s test
Pt’s arm flexed 50-90 deg at shoulder with hand supinated, resist at forearm while pt flexes shoulder
+: pain in bicipital groove indicates bicipital tendonitis of longhead biceps
Empty Can test
Pt holds arms out and internally rotated, press down on forearms while pt resists
+: pain or weakness indicates supraspinatous pathology
Drop-arm test
Pt abducts arm to 90 deg then slowly drops arm
+: arm will drop indicates full thickness tear of supraspinatus
Neer Impingement
Stabilize pt’s shoulder. With arm pronated, passively flex shoulder to fully flexed position
+: pain indicates subacromial bursa or rotator cuff impingement
Hawkins test
Flex shoulder and elbow to 90 deg, passively internally rotate
+ pain indicates rotator cuff or subacromial bursa impingement
Liftoff test
Pt internally rotates arm behind back and internally rotates against physician resistance
+ weakness indicates subscapularis weakness
Cross arm test
Pt passively adducts pt’s arm across their chest and rests pt’s hand on their opposite shoulder
+ test indicates AC joint pathology
