Summarizing Shoulder Conditions Flashcards

1
Q

What is the progressive non-inflammatory disease characterized by degenerative changes in the glenohumeral joint?

A

Glenohumeral joint osteoarthritis

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2
Q

What is the chronic inflammatory disorder of the glenohumeral joint capsule and synovial lining in which initial inflammation is followed by reactive joint capsule fibrosis?

A

Adhesive capsulitis

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3
Q

What is the compression of tissue in the subacromial space?

A

Impingement syndrome

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4
Q

Which tissues may be compressed by impingement syndrome?

A
  • Subacromial bursa (bursitis)
  • Supraspinatus tendon (tendinopathy)
  • Long head biceps (tendinopathy)
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5
Q

What are the muscles affected by rotator cuff tear in order or prevalence?

A
  1. Supraspinatus tendon
  2. Infraspinatus tendon
  3. Subscapularis tendon
  4. Teres minor tendon (rare)
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6
Q

What is the progressive non-inflammatory disease characterized by degenerative changes in the acromioclavicular joint?

A

Acromioclavicular joint osteoarthritis

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7
Q

What is the etiology of primary adhesive capsulitis?

A

Idiopathic

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8
Q

What is the etiology of secondary adhesive capsulitis?

A

Another condition:

  1. Systemic disorders
  2. Shoulder disorders
  3. Non-shoulder disorders
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9
Q

What are some systemic disorders that may cause secondary adhesive capsulitis?

A
  • Diabetes mellitus
  • Thyroid disease
  • Autoimmune disease
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10
Q

The supraspinatus tendon has tendinopathy due to compression in the subacromial space, what term describes this condition?

A

Impingement syndrome

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11
Q

What are some etiologies of impingement syndrome?

A
  1. Functional narrowing (common)
  2. Structural narrowing of subacromial space
  3. Swelling in the subacromial space
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12
Q

What are some examples of functional narrowing leading to impingement syndrome?

A
  • Strength imbalance
  • Tight posterior glenohumeral joint capsule
  • Tight inferior glenohumeral joint capsule
  • Decreased upward rotation of scapula
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13
Q

The following could all lead to what condition?

  • Strength imbalance
  • Tight posterior glenohumeral joint capsule
  • Tight inferior glenohumeral joint capsule
  • Decreased upward rotation of scapula
A

Functional narrowing leading to impingement syndrome

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14
Q

What are some etiologies of rotator cuff tear?

A
  • Age-related degeneration
  • Impingement syndrome
  • Tension overload
  • Trauma (dislocation, FOOSH)
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15
Q

What is the most common etiology of rotator cuff tear in patients over 40 years old?

A

Age-related degeneration

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16
Q

What are the most common etiologies of rotator cuff tear in athletes?

A
  • Impingement syndrome
  • Tension overload
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17
Q

What is the most common acromioclavicular joint condition causing pain?

A

Osteoarthritis

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18
Q

What are some etiologies of AC joint separation?

A
  • Trauma
  • Injury to ACJ capsule and ligament
  • Injury to coracoclavicular ligament (types II-VI)
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19
Q

The following is the typical history of a patient with what condition?

  • Patient is over 60 years old
  • Patient complains of gradual onset of shoulder pain, progressively worsening, aggravated by activity
A

Glenohumeral joint osteoarthritis

20
Q

The following is the typical history of a patient with what condition?

  • Patient is between 40 and 60 years old
  • Gradual onset of shoulder pain
  • Progressively worsening pain
  • Aggravated by activity
A

Adhesive capsulitis in stage 1 (inflammation)

21
Q

The following is the typical history of a patient with what condition?

  • Patient is between 40 and 60 years old
  • Shoulder stiffness
  • Decreasing pain
A

Adhesive capsulitis in stage 2 (fibrosis and contracture)

22
Q

The following is the typical history of a patient with what condition?

  • Patient is between 40 and 60 years old
  • Shoulder stiffness is decreasing over time
  • Pain is minor
A

Adhesive capsulitis in stage 3 (remodels and stretches)

23
Q

Shoulder pain from impingement syndrome may include:

A
  • Anterolateral SH pain
  • Long head biceps tendon
  • Referred pain to deltoid insertion, lateral arm, or forearm
24
Q

The typical patient with impingement syndrome is ___ years old or younger if ___

A

over 35 years old or younger if an athlete

25
Q

Onset of impingement syndrome is related to:

A
  • Occupation (overhead work)
  • Overhead sports
  • 30% unrelated to activity
26
Q

Symptoms of impingement syndrome are aggravated by which activities?

A

Overhead activities

27
Q

The following is the typical history of a patient with what condition?

  • Patient is over 40 years old
  • Shoulder pain or SH pain and weakness
A

Rotator cuff tear

28
Q

The following is the typical history of a patient with what condition?

  • Patient is an athlete younger than 40 years old
  • Shoulder pain or SH pain and weakness
A

Rotator cuff tear

29
Q

Incidence of rotator cuff tear increases with…

A

age

30
Q

The following is the typical history of a patient with what condition?

  • Patient does repetitive overhead work (heavy labor)
  • May have a complication of trauma
A

Osteoarthritis of AC joint

31
Q

Incidence of osteoarthritis of AC joint increases with…

A

patients doing heavy labor

32
Q

The following is the typical history of a patient with what condition?

  • Patient has direct trauma to point of shoulder
A

Separation of AC joint

33
Q

The following are findings in a physical exam of what condition?

  • Decreased active ROM and passive ROM of GHJ with no pattern
  • Possible disuse atrophy
  • Crepitus in GHJ
A

Glenohumeral joint osteoarthritis

34
Q

The following are findings in a physical exam of what condition?

  • Mildly decreased active ROM and passive ROM of GHJ with no pattern
  • Inflammation
A

Stage 1 adhesive capsulitis (inflammation)

35
Q

The following are findings in a physical exam of what condition?

  • Increasing loss of ROM: greatest loss in external rotation of shoulder
  • Capsular pattern possible
A

Stage 2 adhesive capsulitis (fibrosis and contracture)

36
Q

The following are findings in a physical exam of what condition?

  • After loss of motion, ROM of shoulder is improving
A

Stage 3 adhesive capsulitis (remodels and stretches)

37
Q

The following are findings in a physical exam of what condition?

  • Possible tenderness of: greater tubercle, anterolateral SH below acromion, LHBT, ACJ
  • Subacromial crepitus possible
  • Positive impingement test
  • Maybe positive supraspinatus press test
A

Impingement syndrome

38
Q

The following are findings in a physical exam of what condition?

  • Tenderness
  • Subacromial crepitus possible
  • Rotator cuff strength of 4/5 or weaker
  • Weakness of adjacent muscles
  • Positive impingement test
  • Maybe positive supraspinatus press test
  • Maybe positive drop arm test
A

Rotator cuff tear
(Weakness of adjacent muscles indicates massive tear)

39
Q

The following are findings in a physical exam of what condition?

  • AC joint tenderness
  • Pain upon cross body adduction
A

AC joint osteoarthritis

40
Q

The following are findings in a physical exam of what condition?

  • Step defect
  • AC joint tenderness
A

AC joint separation
(Step defect found in types II-VI)

41
Q

The following describes imaging of what condition?

  • Glenohumeral joint destruction in radiographs
A

Glenohumeral joint osteoarthritis

42
Q

The following describes imaging of what condition?

  • Normal radiographs
  • CT/MRI show inflammation and/or thickened joint capsule
A

Adhesive capsulitis

43
Q

The following describes imaging of what condition?

  • Radiographs may show structural causes of impingement
  • MRI is negative for tear
A

Impingement syndrome

44
Q

The following describes imaging of what condition?

  • MRI shows a tear
A

Rotator cuff tear

45
Q

The following describes imaging of what condition?

  • Radiographs show AC joint destruction
A

AC joint osteoarthritis

46
Q

The following describes imaging of what condition?

  • Step defect
A

AC joint separation (types II-VI)
(Type I is negative for step defect)