Shoulder Questions

Question 1

What is the most common shoulder injury

Answer 1

impingement

Question 2

what is the continuum of symptoms related to shoulder impingement syndrome

Answer 2

1. bursitis / impingement
2. partial to full rotator chug tear
3. MASSIve rotator cuff tear
4. rotator cuff arthropathy

Question 3

Clinical of AC joint sprain

Answer 3

• localize pain
• worse with over head activity
• worse putting on bra
• Cross adduction test - positive
• tenderness at AC joint palpation
• Obrains is positive

Question 4

Treatment of AC joint sprain

Answer 4

• Type I and II
  
  • Conservative
    
    • activity modification, ice, NSAIDS, ?, Sling for comfort, early ROM, shoulder girdle complex stabilization and strengthening
• Type III: Sx if doesn’t respond to conservative
• Type IV-VI:
  
  • Surgical = ORIF or distal clavicularresection with reconstruction of the CC ligament

Question 5

Distal Clavicle Osteolysis

Answer 5

• Osteolysis = the pathological destruction or disappearance of bone tissue
• Pathophysiology
  
  • Repetitive microtrauma to distal clavicle leading to osteopenia

X-ray - moth eaten appearance

Question 6

The other name for anterior GH instability

Answer 6

DEAD ARM

Question 7

Clinical Anterior GH instability

Answer 7

• Presentation:
  
  • Hx of trauma
  • pain
  • popping
  • catching
  • locking
  • an unstable sensation
  • stiffness
  • swelling
• Exam:
  
  • Apprehension test
  • relocation test
  • anterior drawer test
  • anterior load and shift
  • sulcus sign
  • generalized ligament laxity
  • neuro (80-90% get axillary nerve damage)

Question 8

Bankers

Answer 8

• avulses the anterior inferior glenoid labrum w/ or w/o some underlying bone from glenoid rim

Question 9

Boney bankart

Answer 9

• avulses the anterior inferior glenoid labrum w/ glenoid rim fracture

Question 10

Hill Sachs lesion

Answer 10

Compression fracture of the posterolateral humeral head - secondary to impact from the anterior rim of glenoid fossa

Question 11

Posterior GH instability cause

Answer 11

4 E 
ethanol 
Epilepsy 
elderly 
electrocution

Question 12

Posterior GH instability

Answer 12

• Arm in adducted, IR position
• Limited ER
• Pain with flexion, adduction and IR
• Posterior Apprehension Test, Posterior Drawer Test, Posterior Load and Shift Test, Sulcus Sign, general ligament laxity, neuro

Question 13

Multidirectional instability AKA

Answer 13

• AMBRI
  
  • Atraumatic
  • Multidirectional
  • Bilateral (frequently)
  • Rehabilitation (often responds to)
  • Inferior capsular shift (best alternative to noon

Question 14

Clinical multidirectional

Answer 14

• Pain, instability, weakness
• paresthesia
• crepitus
• shoulder instability during sleep

Question 15

SlAP Lesion

Answer 15

Superior glenoid Labral tear in the Anterior to Posterior direction

Question 16

Impingement syndrome

Answer 16

• Insidious onset, anterior or lateral shoulder
• exacerbated by overhead activities and lifting objects away from body
• night pain
• stiffness, weakness, and catching might also be present

Question 17

GIRD stands for

Answer 17

Glenohumeral internal rotation deficiiency

Question 18

GIRD

Answer 18

• Loss of internal rotation of the GH joint compared to the contralateral side
• Seen primarily in overhead athletes

Question 19

Frozen Shoulder mechanism

Answer 19

• Unclear etiology
• Contracture and thickening of the capsular tissue
• Fibroblastic proliferation seen on capsular biopsy

Question 20

Presentation

Answer 20

PAIN _ STIFF_ THAWING

• PAIN - Shoulder pain –vague, worse at night and with movements
• STIFF - Reduction in both active and passive ROM
  
  • ER is lost 1st
  • ER and Abduction most significant loss
• THAWING - May have tenderness over anterior or posterior GH joint, increasing ROM