Shoulder problems Flashcards
Posterior shoulder dislocations are by far the most common (T/F)
False
-95% are anterior dislocations
What is a Bankart lesion? How does it arise?
Injury of the glenoid labrum due to anterior shoulder dislocation
What is impingement syndrome?
Pain originating from sub-acromial space, due to catching or rubbing of the rotator cuff tendon on the bone.
What are the intrinsic causes of impingement syndrome?
Osteophytes on the acromion
Injury or overuse of shoulder
Acromion structure (hooked or curved)
Bursitis
What movements and tests are used in Impingement syndrome diagnosis?
Painful arc
Jobe’s test (empty can - supraspinatus)
Hawkins-Kennedy test (impingement)
What are the X-ray signs of impingement syndrome?
Calcification ‘dots’ on the head of humerus
Other than analgaesia, what pharmacological treatment can be given for impingement syndrome?
Subacromial space injections
What surgery can be used in impingement syndrome?
Subacromial decompression surgery
What is the main age range affected by the impingement syndrome?
30-40 year olds
Cuff tear is mostly present in ___-___ year olds
50-60
cuff tear = grey hair
What is noted on examination in patients with cuff tears?
What tests may be carried out?
Weakness
Passive range of movement is much greater than active movement
Muscle wasting
Tests:
- Jobe’s / empty can test (supraspinatus tear)
- External rotation of arm (infraspinatus/ teres minor)
Who is most affected by the frozen shoulder?
Women 40-50
What is the pathology of the frozen shoulder?
contracture and thickening of the glenohumeral ligament
What are the possible frozen shoulder treatments?
Steroid injections
Athroscopic capsular release
manipulation under anaesthesia
What muscle takes over from the rotator cuff muscles for the lever movement in the reverse polarity shoulder replacement?
deltoid
What are the risk factors for development of Carpal Tunnel Syndrome?
female, pregnancy, hormonal fluctuations hypothyroidism diabetes obesity Rheumatoid Arthritis
What is the presentation of carpal tunnel syndrome?
pins and needles numbness pain clumsiness change in shape of the hand -wasting of thenar eminence
Weak abductor pollicus brevis
How is severe carpal tunnel syndorme treated?
Carpal tunnel decompression
-cut trasverse carpal ligament
What are the common causes of cubital tunnel syndrome?
post traumatic
direct pressure by cysts and tumours
arthritis
What nerve is affected in the cubital tunnel syndrome?
Ulnar nerve
What nerve is affected in Carpal tunnel syndrome?
Median nerve
What is the surgery performed for Cubital tunnel syndrome?
Cubital tunnel release
Frozen shoulder only causes pain on abduction (T/F).
What movements are limited in particular?
False
-causes constant pain
External rotation
Abduction
Acromioclavicular joint damage presents with diffuse pain radiating down the shoulder (T/F)
Flase
-patient pinpoints the pain to the location of the joint
The main stabilisers of the clavicle are the ____________ ligaments
coracoclavicular ligaments
