Shoulder Problems and Upper limb nerve entrapment

Question 1

What do we look for with US in a rotator cuff problem

Answer 1

The bursa - you can see the bursa bunching up when they get impingement

Question 2

What is the key sign of shoulder impingement

Answer 2

Pain on movement

Occasionally night pain

Question 3

What are some of they physical signs of a rotator cuff problem

Answer 3

Painful arc
Hawkins Sign
Other impingement tests

Question 4

A painful arc means pain at what height

Answer 4

From 50 -120 degrees

Question 5

If a patient has a crescendo arc (pain does not go away) what does this rule out?

Answer 5

impingement

Question 6

What is calcific tendonitis

Answer 6

Calcium is laid down within the rotator cuff

Question 7

What does the patient describe if the calcium on the tendon ruptures

Answer 7

Excrutiating pain

Question 8

What are the steps in treating shoulder arthritis

Answer 8

Physio
Steroid injection
Trim the bone

Question 9

What is a relatively new treatment for shoulder arthritis and what does it involve?

Answer 9

Reverse arthroplasty

Cup on the humerus and the ball on the glenoid

Question 10

What does a reverse arthroplasty rely on

Answer 10

The deltoid to do all the moving

Question 11

What is the most common type of shoulder dislocation

Answer 11

Anterior (95% of cases)

Question 12

What nerve is at risk of an anterior shoulder dislocation

Answer 12

Axillary nerve

Question 13

Why do you need 2 X Ray views for a shoulder dislocation

Answer 13

It can look absolutely normal in the AP view

Question 14

What group of patients may have a posterior shoulder dislocation

Answer 14

Those with epilepsy after a fit

Question 15

Describe a Hill Sach Lesion

Answer 15

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

Question 16

What type of lesion predisposes you do recurrent dislocation

Answer 16

Bankart Lesion

Question 17

What is a Bankart Lesion

Answer 17

When the glenoid labrum has been torn away from the humerus

Question 18

What is the treatment for a Bankart Repair

Answer 18

Surgical - it needs to be repaired and reattached to the bone

Question 19

What is the acronym for atraumatic injury to the shoulder

Answer 19

AMBRI

Atraumatic 
Multidirectional
Bilateral
Rehabilitation 
Inferior Capsular Shift

Question 20

What is the acronyme for traumatic injury to the shoulder

Answer 20

TUBS

Traumatic
Unilateral
Bankart
Surgery - Bankart repair / latarjet

Question 21

What are some of the symptoms for carpal tunnel

Answer 21

Paraesthesiae in median nerve distribution - numbness or altered sensation
clumsiness
pain
Night time disturbance
Compression of median nerve at carpal tunnel

Question 22

What can we do for carpal tunnel

Answer 22

Night splints
Corticosteroid injection
Surgery

Question 23

What investigation is good for carpal tunnel

Answer 23

Nerve conduction studies

Question 24

What is cubital tunnel

Answer 24

Paraesthesiae in ulnar nerve distribution
Compression around the elbow
Three sites - cubital tunnel, FCU tendon heads and intermuscular fibrous bands just above elbow

Question 25

What is the treatment for cubital tunnel

Answer 25

Surgical release

Question 26

What are some of the indications for decompression in carpal tunnel

Answer 26

Failed conservative treatment
Constant numbness
Weakness

Question 27

What are some of the common symptoms of cubital tunnel syndrome

Answer 27

Pain
Paraesthesia
Numbneess
Weak pinch