Shoulder problems Flashcards
What is subacromial impingement?
Pain and dysfunction resulting from any pathology that decreases the size of the subacromial space or increases the size of its contents
How common is subacromial impingement?
Very
What can cause subacromial impingement?
Bony outgrowth
Inflammation of subacromial bursa
Inflammation of supraspinatus
What is the presentation of subacromial impingement?
Painful arc
Weakness and stiffness
What is the management of subacromial impingement?
Subacromial steroid injection
Physio
Arthroscopic sibacromial decompression
What is adhesive capsulitis?
Frozen shoulder
Chronic but self limiting condition causing fibrosis and severe limitation in active and passive movement of shoulder
What ar the causes of adhesive capsulitis?
Primary= idiopathic Secondary= contributing factors e.g. DM, trauma, previous surgery, thyroid dysfunction
What is the presentation of adhesive capsulitis?
Pain, esp on coracoid process
Progressive reduction in ROM
Stiffness
“Thaws” by 18 months
How is adhesive capsulitis diagnosed?
Clinically
XR to rule out other causes
What is the management of adhesive capsulitis?
Analgesia, physio
Steroid injection
Surgery
What are the causes of rotator cuff tears?
Traumatic
Degenerative
What are the muscles of the rotator cuff?
Supraspinatus
Infraspinatus
Subscapularis
Teres minor
What is the presentation of rotator cuff tears?
Shoulder pain and weakness
Loss of active ROM
What is the management of rotator cuff tears?
Acute= early surgery Chronic= analgesia and physio, steroid injection, surgery if not settling
What are the types of shoulder dislocation?
Anterior= more common Posterior= associated with seizures and electric shocks
What is the presentation of shoulder dislocation?
Pain
Squared off appearance
VERY common
What investigation is done for shoulder dislocation?
XR
What is the management of shoulder dislocation?
Reduction and immobilisation
Surgery
Physio
What are some complications of shoulder dislocation?
Neurovascular injury- esp axillary nerve injury
Redislocation
Rotator cuff tear
Associated fracture
What causes AC separation?
Direct fall onto or blow to shoulder
What is the presentation of AC separation?
Pain
What is the management of AC separation?
Sling
Physio
Surgery
What is a complication of AC separation?
Persistent instability and pain
What are the types of biceps tendon rupture?
Long head of biceps rupture
Distal tendon rupture= rare
Who is long head of biceps rupture seen in?
> 50s
Can occur with minimal trauma in older patients
What is the presentation pf long head of biceps rupture?
Popeye sign
Elbow flexion remains good
Weakness in supination
What is the management of long head of biceps rupture?
Consevative
Surgery cosmetic only
What is the presentation and management of distal biceps tendon rupture?
Seen in weightlifting
Urgent surgery
