Shoulder Pain Flashcards
Shoulder impingement syndrome:
Where is the pathology?
It is an umbrella term and has many conditions under it!
When do they get pain?
In the subacromial space
Pain on abduction
Shoulder impingement syndrome:
Rotator cuff tear:
- What tendons can be torn?
- What 2 symptoms will the patient complain of?
- What will an USS show?
- What will an MRI show?
Supraspinatus tendon
Adjacent subscapularis and infraspinatus
Pain and weakness
Shows if there is a tear or not
Can quantify muscle wasting which can be a useful prognostic indicator
Adhesive capsulitis:
What is the more common name for it?
What symptoms do they complain of?
IT HAS NO OBVIOUS TRIGGER!
When do the symptoms tend to be worse?
Frozen shoulder
Stiffness and/or pain
At night
This may be because the effects of gravity when laying down cause the muscles and tendons in the shoulder to settle in a slightly different position, decreasing blood flow to the area and aggravating the pain of tendon issues like tendonitis.
Osteoarthritis:
What could contribute to OA in the shoulder?
Manual labour
Walking with stick
Traumatic or complex causes:
What can cause a full-thickness rotator cuff tear?
What are the group of rotator cuff muscles? - use mneumonic SITS
Where would referred pain C5 go to?
Where would referred pain from C6, 7 & 8 go to?
What in the thorax could cause pain?
What in the lung apices could cause pain?
What may affect the muscles, which commonly presents with GCA?
Dislocation or traction
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Deltoid region
Superior border of the scapula
Myocardium - ACS
Cancer
Polymyalgia rheumatica
Management:
Analgesia and steroids for all types of shoulder pain.
What is surgery is done for OA?
What surgery is done for a frozen shoulder?
Frozen shoulder usually resolves though!
What is needs to be done for full-thickness rotator cuff tear?
Joint replacement
Manipulation under anaesthesia or capsular release
Prompt surgical repair
