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Orthopaedics > Shoulder problems > Flashcards

Shoulder problems Flashcards

1
Q

What is frozen shoulder also known as?

A

adhesive capsulitis

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2
Q

In what group of ppl is frozen shoulder more common?

A

middle age female

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3
Q

What condition is frozen shoulder associated w?

A

DM

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4
Q

What can be found on examination in a patient with frozen shoulder?

A

Active and passive block to all movements

External rotation is usually reduced compared to other shoulder

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5
Q

What is the management of frozen shoulder?

A
  • NSAIDs
  • Physio
  • Oral intra-articular steroids
  • Surgery
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6
Q

What causes impingement syndrome?

A

tendonitis of RC muscles as they pass through subacromial space

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7
Q

What muscle is usually affected in impingement syndrome?

A

supraspinatus

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8
Q

What are the symptoms of impingement syndrome?

A

insidious onset of pain

exacerbated by overhead activities and lifting objects away from the body

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9
Q

What can be found on examination in a patient with impingement syndrome?

A

Tenderness over the greater tuberosity
Painful arc (60-120)
Positive Neer’s and Hawkin’s sign

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10
Q

What is the treatment for impingement syndrome?

A

steroid injections

surgery - remove impinging structures or widen subacromial space

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11
Q

What are the types of shoulder dislocation? which one is the most common?

A
  1. Glenohumeral - most common
  2. Acromioclavicular
  3. Sternoclavicular
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12
Q

What is the most common type of GH dislocation?

A

anterior

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13
Q

What is the mechanism of injury in anterior shoulder dislocations

A

anteriorly directed force on arm when shoulder is abducted and externally rotated

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14
Q

What is the management of shoulder dislocations?

A
  1. REDUCTION
  2. Check neurovascular status pre and post reduction
  3. XR post reduction to ensure no fracture
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15
Q

What is a Bankart lesion?

A

avulsion of the anterior glenoid labrum due to anterior shoulder dislocation

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16
Q

What is a Hill-Sachs lesion?What causes them?

A

cortical depression in the posterolateral head of the humerus
secondary to recurrent anterior shoulder dislocations

17
Q

What may be found on examination of a patient with ACJ arthritis ?

A

tenderness over the ACJ
pain on abduction (160-180)
positive scarf test

18
Q

How would you distinguish between a frozen shoulder and osteoarthritis?

A

Osteoarthritis - usually older patients, may have audible crepitus
XR only true way to distinguish

19
Q

What are the muscles of the rotator cuff? what are their actions?

A

Supraspinatus - abduction and external rotation
Infraspinatus - external rotation
Teres minor - external rotation
Subscapularis - internal rotation

20
Q

What is the main function of the rotator cuff?

A

stabilise the shoulder

21
Q

What are the different mechanisms that can lead to rotator cuff tear?

A
  • chronic degenerative (older pts) - stress from repeated movements
  • chronic impingement
  • acute avulsion (younger following falls)
  • iatrogenic
22
Q

Where do the majority of rotator cuff tears occur?

A

supraspinatus, infraspinatus and teres minor (SIT)

23
Q

What are the symptoms in rotator cuff tears

A

Pain

weakness

24
Q

Explain how you test the rotator cuff muscles

A

Supraspinatus - pain/weakness in Jobe position
Infraspinatus - LAG sign
Subscapularis - lift off test or belly press
There is loss of active ROM and intact passive ROM

25
Q

What imaging is used for rotator cuff tears, what are they useful for?

A

XR - calcific tendonitis, type of acromion

MRI - diagnostic standard

26
Q

What are the main types of shoulder fractures?

A

clavicular

proximal humeral fractures

27
Q

what group of ppl are clavicular fractures common in?

A

cyclists

28
Q

What are the complications of clavicular fractures?

A

brachial plexus injuries
subclavian vessel tear
pneumothorax

29
Q

What is the treatment of clavicular fractures?

A

broad arm sling and ORIF

30
Q

When do most proximal humeral fractures occur?

A

FOOSH

31
Q

What is the management of proximal humeral fractures and what does it depend on?

A 
Minimally displaced - conservative 
Surgery needed if:
- open fracture
- pathological fracture 
- 3/4 fractures
- neurovascular injury

Orthopaedics (11 decks)

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