Shoulder problems Flashcards
What are the features of frozen shoulder (adhesive capsulitis)?
Painful, stiff movement
Limited movement in all directions, but external rotation is affected more than internal rotation or abduction
Both active and passive movement are affected
Typically have a painful freezing phase, an adhesive phase and a recovery phase
Lasts between 6 months to 2 years
What condition may also be associated with frozen shoulder?
Diabetes
What treatment is given for frozen shoulder?
NSAIDs
Oral corticosteroids and intra-articular corticosteroids
Physiotherapy
What conditions may present with rotator cuff injury?
Subacromial impingement syndrome (includes subacromial bursitis, calcific tendonitis)
Rotator cuff tears
Rotator cuff arthropathy (shoulder arthritis with tear)
What are signs of rotator cuff injury?
Painful arc of abduction:
In subacromial impingement = pain at 60-120 degrees
In rotator cuff tears = pain at 0-60 degrees
Tenderness over anterior acromion
What movement doe the following muscles perform and what is their nerve innervation: Supraspinatus Infraspinatus Teres Minor Subscapularis
Supraspinatus:
Abducts
Suprascapular nerve
Infraspinatus:
External rotation
Suprascapular nerve
Teres Minor:
External rotation
Axillary nerve
Subscapularis:
Internal rotation
Upper and lower subscapular nerve
What treatment can be given in rotator cuff injury?
Conservative:
Simple analgesia
Physiotherapy to recruit deltoid muscle to achieve abduction
Subacromial space injection:
Contains steroid and local anaesthetic
Surgical intervention:
Likely to be repair of tear using sutures and bone anchors to reattach
Arthroplasty may be needed in cuff arthropathy
Why is it important to make it clear that if a patient does NOT want surgical intervention?
If administering injection with steroids, it prevents them from having surgical intervention with implants for a period of 3 months minimum due to the risk of infection of surgery
What is the most commonly injured nerve in shoulder dislocation?
Axillary nerve
