Shoulder pathology Flashcards
what is Biceps Tendinitis and Tenosynovitis
Pain over anterolateral shoulder that radiates down
Inflammation of the long head of the biceps tendon(tendinitis) within the bicipital groove and the tendon sheath(tenosynovitis)
appearance of Biceps Tendinitis and Tenosynovitis
Enlarged thickened hypoechoic tendon
what is acute tendinitis
Rotator Cuff tendons become inflamed or irritated.
acute shoulder tendinitis comon is
Common with athletes and AKA:
Swimmer’s shoulder
Pitcher’s shoulder
Tennis shoulder
acute tendonitis symptoms (4)
Pain triggered by arm movement
Swelling in front of shoulder
Stiffness
Clicking sound with arm movement
what is chronic tendonitis
Long term inflammation and degeneration of tissue in one or more of the tendons of the shoulder
Calcifications may form and restrict movement within the shoulder
when is chronic tendonitis more likely to occur
due to repetitive motions over time which puts stress on the tendons
chronic tendinitis symptoms (4)
Pain and discomfort for my than 6 months
Pain worsened during use, at night, or in the morning
Stiffness
Loss of strength
The shoulder is built for _____, not _____
MOTION NOT STABILITY
injury rate of shoulder depends on (3)
Shallowness of glenoid fossa
Laxity of ligaments
Strength of muscles
3 types of shoulder instability
shoulder subluxation
shoulder dislocation
shoulder seperation
what is Shoulder subluxation
Incomplete or partial dislocation
what is Shoulder dislocation
Complete dislocation of the GH joint
Most common anteriorly and inferiorly
what is shoulder separation
Complete dislocation of the AC joint
glenohumeral instability is most common wher
anterointerior
glenohumeral instability caused by
overstretching of the middle and inferior glenohumeral ligaments.
what is SUBACROMIAL IMPINGEMENT SYNDROME
Entrapment, or impingement, of the structures in the subacromial space – between the CA arch and greater tuberosity.
Subacromial space contains (3)
rotator cuff tendons (primarily supraspinatus), long head of biceps tendon, subacromial bursa.
3 stages of impingement syndrome with age and appearance
1. <25 years old, overuse injury
edema
2. 25-40 years old,
fibrosis, bursal thickening
3. >50 years old
partial or ft tear or rupturewhat is rotator cuff interval
hypoechoic area surrounding the cross-sectioned long head of the biceps tendon
this area could be mistaken for a rotator cuff tear
varies in size and may not be apparent in some individuals
thinning of the rotator cuff at the supraspinatus-infraspinatus interface is a________ and should not be mistaken for a _________.
normal finding
partial thickness tear
thinning of the rotator cuff at the supraspinatus-infraspinatus interface seen in patients with
rheumatoid arhtritis
Most commonly torn rotator cuff muscle
the supraspinatus.
rotator cuff tears/failure usually from
subacromial impingement
may be also a traumatic tear
complete tear
Result of repeated movements or sudden injury
Tears all the way through to the tendon or it can rip the tendon off of the bone
complete tear symptoms
Clicking or popping when you move your arm
Pain when you move your arm or lie on it
Weakness in arm
Full Thickness Rotator Cuff Tears visualized criteria
1.Complete non visualization of the cuff
“bare shoulder” or massive tear
2. Localized or focal nonvisualization of cuff
Occur in anterolateral critical zone
with deltoid herniation sign
3. Discontinuity of the cuff
Smaller tear associated with fluid collection from SA-SD bursa
with double cortex sign
4. Abnormal cuff echogenicity
Focal area of increased or decreased echogenicity
Least reliable
YEah this is a long card but they gotta go together
full thickness tear sono signs (2)
Deltoid Herniation sign -defined pieces of cuff seperated by herniation of deltoid muscle into tear
Double cortex sign-bright reflective line at the surface of cartilage overlying the humeral head in the presence of focal overlying fluid
what is Critical Zoneof the rotator cuff
area of relative avascularity on the supraspinatus muscle tendon near its insertion (tenoperiosteal junction) on the greater tubercle of the humerus.
key difference between partial and full thickness rotator cuff tear
FTRC tears allow communication of the glenohumeral and the SA-SD bursa, partial thickness tears do not
both Partial- and full-thickness rotator cuff tears should be always verified by
verified in two orthogonal directions.
partial tears happen
over time while repeating the same arm motion
Common in tennis and baseball
partial tear symptoms
Symptoms can include
Difficulty lifting arm
Weakness in shoulder
Trouble doing things you normally do
3 types of partial tears
intrasubstance
articular surface
bursal surface
intrasubstance PT is
most common
articular surface PT description
early supraspinatus tear within
the critical zone, associated with focal cortical
irregularity of the humerus
minor criteria for tears
- intra or extra articular fluid collections
- abnormal contour of subdeltoid bursa
- elevation of humeral head
- abnormal contour of subdeltoid bursa description
- concavity= medium or large tear
- thickness – normal SA-SD bursa measures 2 mm or less
elevation of humeral head description
- massive tear
- compare with normal side
