Shoulder pathology Flashcards by FWU Enterprise

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)

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appearance of Biceps Tendinitis and Tenosynovitis

Enlarged thickened hypoechoic tendon

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what is acute tendinitis

Rotator Cuff tendons become inflamed or irritated.

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acute shoulder tendinitis comon is

Common with athletes and AKA:
Swimmer’s shoulder
Pitcher’s shoulder
Tennis shoulder

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acute tendonitis symptoms (4)

Pain triggered by arm movement
Swelling in front of shoulder
Stiffness
Clicking sound with arm movement

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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

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when is chronic tendonitis more likely to occur

due to repetitive motions over time which puts stress on the tendons

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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

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The shoulder is built for _____, not _____

MOTION NOT STABILITY

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injury rate of shoulder depends on (3)

Shallowness of glenoid fossa
Laxity of ligaments
Strength of muscles

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3 types of shoulder instability

shoulder subluxation
shoulder dislocation
shoulder seperation

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what is Shoulder subluxation

Incomplete or partial dislocation

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what is Shoulder dislocation

Complete dislocation of the GH joint

Most common anteriorly and inferiorly

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what is shoulder separation

Complete dislocation of the AC joint

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glenohumeral instability is most common wher

anterointerior

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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 rupture

what 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 Zone of 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

1. intra or extra articular fluid collections 2. abnormal contour of subdeltoid bursa 3. elevation of humeral head

2. 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