Shoulder specific pain Flashcards
Trauma
Fracture
Dislocation
CSP disc
SLAP
Inflammatory
PMR
RA
SLE
Pseudo GOUT
PMR
- Bilateral shoulder or hip
- Sudden onset or equal intensity shoulder Px
- 50 or above
- Female
- Stiffness for at least 45 minutes after waking or periods of rest (person may have difficulty turning in bed, rising from chair, or raising arms above shoulders or squatting.
- Worse with movement or after rest
- Constitutional signs
- Giant cell arteritis
RA
Swelling
Early morning stiffness
Recurring pain or tenderness in any joint (3+joints)
Inability to move a joint normally
Obvious redness and warmth
Unexplained weight loss, fever, or weakness combined with joint pain, myalgia, night sweats
Symptoms such as these that last for more than 2 weeks
SLE
- Fatigue and fever
- Butterfly rash and photosensitivity
- Joint pain and swelling
- Chest pain (pleuritis or pericarditis)
- Kidney issues (swelling, blood in urine)
- Neurological symptoms (seizures, headaches)
- Raynaud’s phenomenon
Endocrine
AD cap
Fibro
Myopathy - hypothyroid
AD CAP
Mean age 55
ER reduced by 50%
Loss of ROM greater than 25%
Parkinson’s
Thyroid
DM
Women 40-60
Freezing stage:
Lasts between 6 weeks to 9 months.
Gradual onset of severe shoulder pain, especially at night or with movement.
Increasing stiffness of the shoulder, making movement difficult.
Active and passive range of motion becomes increasingly limited.
Frozen stage:
Lasts 4 to 6 months.
Pain may start to diminish but stiffness worsens significantly.
Shoulder movements are significantly restricted, especially external rotation, abduction, and flexion.
Difficulty performing daily activities like reaching overhead, dressing, or grooming.
Thawing stage
Can last from 6 months to 2 years.
Gradual restoration of shoulder movement and reduction in pain.
Slowly increasing range of motion, but it may not return to full pre-condition levels.
Angiogenesis into capsule tissue, which produces collagen fibre proliferation, granulation and contracture of the capsuloligamentous complex.
Fibro
- The hallmark symptom of fibromyalgia is widespread pain that affects both sides of the body, above and below the waist.
- 75-90% of diagnosed cases are in women.
- ages of 30 and 50 most common.
- The pain is often described as a constant, dull ache that lasts for at least three months.
- Pain is typically felt in muscles, ligaments, and tendons rather than in joints.
- Fibromyalgia can also be associated with sleep disorders such as sleep apnea and restless leg syndrome.
- Tension type headaches
- IBS
- Depression
Infection
- Redness, swelling, fever, Heat
- Prev surgery or trauma
- Immunocompromised (really old or really young)
Septic arthritis
TB/osteomyelitis
Parsonage turner syndrome
Malignancy
- Unexplained weight loss
- Fatigue/malaise
- Fever
- Night sweats
- Loss of appetite
- Generalised Pain/feeling of unwell
- Frequent infections
Breast Cancer
- A new lump or mass in the breast.
- Changes in breast shape or size.
- Skin dimpling or puckering.
- Nipple retraction, discharge, or changes.
- Swelling or pain in the breast or armpit.
Women over 50
Late menopause (over 55)
Family Hx
HRT for more than 5 years
Not having children/mot breast feeding/first child over 30
Contraceptive pill
Last mammogram
Lung Cancer
- Persistent cough and coughing up blood.
- Shortness of breath and wheezing.
- Chest pain.
- Unexplained weight loss and fatigue.
- Recurring infections like pneumonia.
*Over 65
*Male
*Smokers
Pancreatic tumour
- Abdominal pain or discomfort (often radiates to the back)
- Unexplained weight loss
- Loss of appetite
- Jaundice (yellowing of the skin and eyes)
- Dark urine and pale stools
- Nausea and vomiting
- New-onset diabetes or worsening of existing diabetes
Bone tumor:
Osteosarcoma
Ewing sarcoma
Chondrosarcoma
Chondrosarcoma
- Affects adults, usually over 40 years old.
- Develops in cartilage cells and can occur in any bone but commonly in the pelvis, thighs, and shoulder.
- Typically slow-growing, though some types can be more aggressive.
- Symptoms include pain, swelling, or a palpable lump.
Osteosarcoma
- Most common primary malignant bone tumor.
- Affects children, adolescents, and young adults (10–25 years old).
- Typically occurs in long bones (especially around the knee or upper arm).
- Symptoms include bone pain, swelling, and sometimes fractures.
- Requires aggressive treatment (surgery, chemotherapy).
Ewings sarcoma
- Affects children and adolescents, typically between ages 10–20.
- Can occur in any bone but commonly affects the pelvis, legs, or arms.
- Causes localized pain, swelling, and sometimes fever or weight loss.
- Highly aggressive, often requiring combined chemotherapy, radiation, and surgery.
