Shoulder Pathology Flashcards
Glenohumeral joint structure
Ball and socket. Relies heavily on muscles and ligature for stability.
Primary ligament of the acromioclavicular joint
Coracoclavicular ligament
Sternoclavicular ligaments
Anterior and posterior scternoclavicular ligaments, interclavicular ligature
Frozen shoulder
The shoulder joint capsule thickens and tightens around the shoulder, restricting motion. Also called adhesive capsulitis.
Onset of frozen shoulder
Can be sudden or gradual, usually around 45-60 years old.
Which movements are particularly restricted in frozen shoulder?
Abduction and external rotation
Stages of frozen shoulder
Freezing, frozen and thawing
Freezing stage of frozen shoulder
Painful and restricted ROM, lasts 6-12 weeks
Frozen stage of frozen shoulder
Less painful, but more stiff. Lasts 4-6 months
Thawing stage of frozen should
Motion gradually improves over a period of as much as a year.
Main bursa of the shoulder
Subacromial, subscapular, subcoracoid, subdeltoid
Subacromial bursitis
Internal rotation irritates the bursa. This is felt at the lesser tuberosity.
Subcoracoid bursitis
Irritated by lifting weight overhead.
Supraspinatus tendinitis
Fairly common due to impingement and relatively poor oxygenation.
Infraspinatus tendinitis
Irritated by sustained abduction, external rotation and overhead activities.
Bicipital tendinitis
Due to repetitive trauma from overhead flexion and rotation.
Biceps brachii injury
The long head is more susceptible to damage.
Signs and symptoms of biceps injury
Pain in the upper arm, popping sound at time of injury, bruising, weakness in flexion and supination, bulged biceps.
Impingement syndrome
Compromised space between the coracoacromial arch and the proximal humerus.
Sprain
Injury to a ligament
Strain
Injury to a muscle or tendon
What causes sprains?
Overstretching a ligament
What causes strains?
Excessive force being applied to a muscle.
Acromioclavicular sprains
Commonly called a separated shoulder. Due to an injury that causes displacement of the acromion from the clavicle.
Why is the glenohumeral joint more susceptible to dislocation?
The head of the humerus and the glenoid fossa don’t fit well together.
Elbow pathologies
epicondylitis, tendinitis, dislocations, bursitis, sprains and strains.
Elbow dislocation
The ulna and radius move out of place in relation to the humerus. Second most common type of dislocation.
Lateral epicondylitis
Pain in the lateral aspect of the elbow. Also called tennis elbow.
What causes lateral epicondylitis?
A tear in extensor muscles. Common in gripping activities.
Signs and symptoms of lateral epicondylitis
Gradual or intermittent mild ache with the most tender point being at the anterior portion of the epicondyle.
Medial epicondylitis
Caused by a strain to the wrist flexors. Called Golfer’s elbow.
Olecranon bursitis
Pain and swelling in the elbow. May be due to a fall on the elbow or be idiopathic.
De Quervain’s tenovaginitis
Two tendons which share a sheath rub against one another. Causes pain at the distal, lateral forearm and a positive Finkelstein’s test
Skier’s/Game keeper thumb
Injury to the collateral ligament of the MCP joint. Can lead to adhesions and decreased flexion. Usually caused by forceful hyperextension or abduction of the thumb.
Mallet fingers
The result of a rupture or avulsion of the extensor tendon where it inserts into the distal phalanx of the fingers.
Jammed fingers
A sprain to the joint of the finger. Causes a painful and inflamed joint.
Jersey fingers
A tear of one or more flexor tendons in a finger at the distal phalanx. Causes, pain, swelling, bruising and an inability to bend the joint.
Bennett fracture
Fracture to the base of the thumb. From forced abduction, usually punching or falling.
Rupture of extensor pollicis longus
Often found with fracture of the distal radius, synovitis or rheumatoid arthritis. Causes pain in wrist and inability to straighten thumb.
Volkman’s Ischemic Contracture
Contracture of the hand following muscular death and replacement by fibrous tissue. Caused by trauma that prevents blood flow for at least 6 hours.
Congenital Pseudoarthrosis
Movement of a bone at the location of fracture due to inadequate healing. Common in clavicle, radius and ulna.
Dupuyten’s contractrue
Contracture ot the palmar aponeurosis.
Causes of Dupuyten’s contracture
Painless proliferation of fibroblasts from inflammatory fibrosis. This transforms the contractile tissue into non-contractile tissue.
Risk factors in Dupuyten’s contracture
Alcoholism, diabetes, liver disorders, epilepsy, men over 30 and women over 45.
Signs and symptoms of Dupuyten’s contracture
Small node on the palm and then progresses to the flexor side of the fingers.
