Shoulder Questions Flashcards
What is the most common shoulder injury
impingement
what is the continuum of symptoms related to shoulder impingement syndrome
- bursitis / impingement
- partial to full rotator chug tear
- MASSIve rotator cuff tear
- rotator cuff arthropathy
Clinical of AC joint sprain
- localize pain
- worse with over head activity
- worse putting on bra
- Cross adduction test - positive
- tenderness at AC joint palpation
- Obrains is positive
Treatment of AC joint sprain
- Type I and II
- Conservative
- activity modification, ice, NSAIDS, ?, Sling for comfort, early ROM, shoulder girdle complex stabilization and strengthening
- Conservative
- Type III: Sx if doesn’t respond to conservative
- Type IV-VI:
- Surgical = ORIF or distal clavicularresection with reconstruction of the CC ligament
Distal Clavicle Osteolysis
- Osteolysis = the pathological destruction or disappearance of bone tissue
- Pathophysiology
- Repetitive microtrauma to distal clavicle leading to osteopenia
X-ray - moth eaten appearance
The other name for anterior GH instability
DEAD ARM
Clinical Anterior GH instability
- 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)
Bankers
- avulses the anterior inferior glenoid labrum w/ or w/o some underlying bone from glenoid rim
Boney bankart
- avulses the anterior inferior glenoid labrum w/ glenoid rim fracture
Hill Sachs lesion
Compression fracture of the posterolateral humeral head - secondary to impact from the anterior rim of glenoid fossa
Posterior GH instability cause
4 E ethanol Epilepsy elderly electrocution
Posterior GH instability
- 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
Multidirectional instability AKA
- AMBRI
- Atraumatic
- Multidirectional
- Bilateral (frequently)
- Rehabilitation (often responds to)
- Inferior capsular shift (best alternative to noon
Clinical multidirectional
- Pain, instability, weakness
- paresthesia
- crepitus
- shoulder instability during sleep
SlAP Lesion
Superior glenoid Labral tear in the Anterior to Posterior direction
Impingement syndrome
- 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
GIRD stands for
Glenohumeral internal rotation deficiiency
GIRD
- Loss of internal rotation of the GH joint compared to the contralateral side
- Seen primarily in overhead athletes
Frozen Shoulder mechanism
- Unclear etiology
- Contracture and thickening of the capsular tissue
- Fibroblastic proliferation seen on capsular biopsy
Presentation
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
