Shoulder pathologies

Question 1

Anterior dislocation incidence

Answer 1

97% of dislocations

Question 2

Anterior dislocation MOI

Answer 2

Violent external rotation and abduction

Question 3

Anterior dislocation associated injuries

Answer 3

Nerve damage

Bankart and Hill-Sachs lesions

Question 4

Posterior dislocation incidence

Answer 4

2-4%

Question 5

Posterior dislocation MOI

Answer 5

Humeral head forced posteriorly in internal rotation while arm abducted
May be caused by violent muscle contractions

Question 6

Posterior dislocation associated injuries

Answer 6

Surgical neck fracture
Greater tuberosity fracture
Reverse Hill-Sachs lesion

Question 7

Posterior dislocation presentation

Answer 7

Arm held in internal rotation

Unable to externally rotate

Question 8

Inferior dislocation incidence

Answer 8

1%

Question 9

Inferior dislocation MOI

Answer 9

Forceful hyperabduction

Or direct axial loading on fully abducted arm with elbow extended and pronated

Question 10

Inferior dislocation associated injuries

Answer 10

Axillary and arterial nerve damage

Rotator cuff and internal capsule tears

Question 11

Inferior dislocation presentation

Answer 11

Unable to adduct arm

Question 12

What is a Hill-Sachs lesion

Answer 12

Compression fracture of posterolateral humeral head due to compression of the anteroinferior part of the glenoid when the humerus is anteriorly dislocated

Question 13

Reverse Hill-Sachs lesion

Answer 13

Compression of anterior superior aspect of humeral head when humerus is posteriorly dislocated.

Question 14

What is a bankart lesion

Answer 14

Detachment of anterior inferior labrum from underlying glenoid following dislocation
Usually consequence of repeated anterior dislocations

Question 15

What is TUBS

Answer 15

Traumatic unilateral lesion , With bankart lesion,

Usually requires surgery

Question 16

AMBRI

Answer 16

Atraumatic multidirectional frequently bilateral, responds to rehab

Question 17

Superior labral anterior posterior lesions

Answer 17

Damage to superior aspect of glenoid labrum

Can extend to long head of biceps and glenohumeral ligaments

Question 18

SLAP MOI

Answer 18

Falls

Repetitive overhead motions

Question 19

SLAP- which type of lesion is most common?

Answer 19

Type 2

Question 20

SLAP- types

Answer 20

I- fraying, intact biceps tendon
II- Superior labrum torn off the glenoid, stripping of biceps tendon
III- Bucket handle tear of superior labrum
IV- Buclet handle tear of superior labrum, extends to biceps tendon

Question 21

What is sub acromial pain syndrome (SAPS)

Answer 21

Non traumatic
Usually unilateral
Pain localised to acromion

Rotator cuff tear, supraspinatus most common

Question 22

Rotator cuff tear MOI

Answer 22

Can be acute or chronic

FOOSH, dislocation

Question 23

Adhesive capsulitis presentation

Answer 23

Global restriction of movements
3 stages:
Freezing- increased pain with movement, at night, progressive loss of motion. Lasts 2-9 months
Frozen- pain starts to diminish, ROM more limited. Lasts 4-12 months
Thawing- Gradual restoration of motion. Lasts 12-42 months

Question 24

What is OA

Answer 24

Gradual breakdown of articular cartilage and other joint tissues

Question 25

AC joint injuries

Answer 25

FOOSH

Blunt trauma to abducted shoulder

Question 26

Age and gender adhesive capsulitis

Answer 26

Higher prevalence in women

Usually 40-59

Question 27

Adhesive capsulitis MOI

Answer 27

Primary- idiopathic

Secondary- following trauma or surgery