Shoulder Problems and Upper limb nerve entrapment Flashcards
What do we look for with US in a rotator cuff problem
The bursa - you can see the bursa bunching up when they get impingement
What is the key sign of shoulder impingement
Pain on movement
Occasionally night pain
What are some of they physical signs of a rotator cuff problem
Painful arc
Hawkins Sign
Other impingement tests
A painful arc means pain at what height
From 50 -120 degrees
If a patient has a crescendo arc (pain does not go away) what does this rule out?
impingement
What is calcific tendonitis
Calcium is laid down within the rotator cuff
What does the patient describe if the calcium on the tendon ruptures
Excrutiating pain
What are the steps in treating shoulder arthritis
Physio
Steroid injection
Trim the bone
What is a relatively new treatment for shoulder arthritis and what does it involve?
Reverse arthroplasty
Cup on the humerus and the ball on the glenoid
What does a reverse arthroplasty rely on
The deltoid to do all the moving
What is the most common type of shoulder dislocation
Anterior (95% of cases)
What nerve is at risk of an anterior shoulder dislocation
Axillary nerve
Why do you need 2 X Ray views for a shoulder dislocation
It can look absolutely normal in the AP view
What group of patients may have a posterior shoulder dislocation
Those with epilepsy after a fit
Describe a Hill Sach Lesion
When an anterior shoulder dislocation is relocated into the the bottom of the glenoid by mistake - as if someone has made a hole in the top of an egg
What type of lesion predisposes you do recurrent dislocation
Bankart Lesion
What is a Bankart Lesion
When the glenoid labrum has been torn away from the humerus
What is the treatment for a Bankart Repair
Surgical - it needs to be repaired and reattached to the bone
What is the acronym for atraumatic injury to the shoulder
AMBRI
Atraumatic Multidirectional Bilateral Rehabilitation Inferior Capsular Shift
What is the acronyme for traumatic injury to the shoulder
TUBS
Traumatic
Unilateral
Bankart
Surgery - Bankart repair / latarjet
What are some of the symptoms for carpal tunnel
Paraesthesiae in median nerve distribution - numbness or altered sensation
clumsiness
pain
Night time disturbance
Compression of median nerve at carpal tunnel
What can we do for carpal tunnel
Night splints
Corticosteroid injection
Surgery
What investigation is good for carpal tunnel
Nerve conduction studies
What is cubital tunnel
Paraesthesiae in ulnar nerve distribution
Compression around the elbow
Three sites - cubital tunnel, FCU tendon heads and intermuscular fibrous bands just above elbow
What is the treatment for cubital tunnel
Surgical release
What are some of the indications for decompression in carpal tunnel
Failed conservative treatment
Constant numbness
Weakness
What are some of the common symptoms of cubital tunnel syndrome
Pain
Paraesthesia
Numbneess
Weak pinch
