Shoulder problems

Question 1

What is subacromial impingement?

Answer 1

Pain and dysfunction resulting from any pathology that decreases the size of the subacromial space or increases the size of its contents

Question 2

How common is subacromial impingement?

Answer 2

Very

Question 3

What can cause subacromial impingement?

Answer 3

Bony outgrowth
Inflammation of subacromial bursa
Inflammation of supraspinatus

Question 4

What is the presentation of subacromial impingement?

Answer 4

Painful arc

Weakness and stiffness

Question 5

What is the management of subacromial impingement?

Answer 5

Subacromial steroid injection
Physio
Arthroscopic sibacromial decompression

Question 6

What is adhesive capsulitis?

Answer 6

Frozen shoulder

Chronic but self limiting condition causing fibrosis and severe limitation in active and passive movement of shoulder

Question 7

What ar the causes of adhesive capsulitis?

Answer 7

Primary= idiopathic
Secondary= contributing factors e.g. DM, trauma, previous surgery, thyroid dysfunction

Question 8

What is the presentation of adhesive capsulitis?

Answer 8

Pain, esp on coracoid process
Progressive reduction in ROM
Stiffness
“Thaws” by 18 months

Question 9

How is adhesive capsulitis diagnosed?

Answer 9

Clinically

XR to rule out other causes

Question 10

What is the management of adhesive capsulitis?

Answer 10

Analgesia, physio
Steroid injection
Surgery

Question 11

What are the causes of rotator cuff tears?

Answer 11

Traumatic

Degenerative

Question 12

What are the muscles of the rotator cuff?

Answer 12

Supraspinatus
Infraspinatus
Subscapularis
Teres minor

Question 13

What is the presentation of rotator cuff tears?

Answer 13

Shoulder pain and weakness

Loss of active ROM

Question 14

What is the management of rotator cuff tears?

Answer 14

Acute= early surgery
Chronic= analgesia and physio, steroid injection, surgery if not settling

Question 15

What are the types of shoulder dislocation?

Answer 15

Anterior= more common
Posterior= associated with seizures and electric shocks

Question 16

What is the presentation of shoulder dislocation?

Answer 16

Pain
Squared off appearance
VERY common

Question 17

What investigation is done for shoulder dislocation?

Answer 17

XR

Question 18

What is the management of shoulder dislocation?

Answer 18

Reduction and immobilisation
Surgery
Physio

Question 19

What are some complications of shoulder dislocation?

Answer 19

Neurovascular injury- esp axillary nerve injury
Redislocation
Rotator cuff tear
Associated fracture

Question 20

What causes AC separation?

Answer 20

Direct fall onto or blow to shoulder

Question 21

What is the presentation of AC separation?

Answer 21

Pain

Question 22

What is the management of AC separation?

Answer 22

Sling
Physio
Surgery

Question 23

What is a complication of AC separation?

Answer 23

Persistent instability and pain

Question 24

What are the types of biceps tendon rupture?

Answer 24

Long head of biceps rupture

Distal tendon rupture= rare

Question 25

Who is long head of biceps rupture seen in?

Answer 25

> 50s

Can occur with minimal trauma in older patients

Question 26

What is the presentation pf long head of biceps rupture?

Answer 26

Popeye sign
Elbow flexion remains good
Weakness in supination

Question 27

What is the management of long head of biceps rupture?

Answer 27

Consevative

Surgery cosmetic only

Question 28

What is the presentation and management of distal biceps tendon rupture?

Answer 28

Seen in weightlifting

Urgent surgery