Upper limb soft tissue injury Flashcards
What is the presentation of a frozen shoulder?
Painful phase, followed by stiffness
Painful external rotation
Subsequent ‘thawing’ to resolution
Can last for 1-3 years
What is the mechanism of injury in frozen shoulder?
Primary
Secondary to trauma
Surgery
Reduced mobilisation
What is the mechanism of injury in supraspinatus tendinopathy?
Overhead activities
Joint space narrowing
What are the features of supraspinatus tendinopathy?
Positive empty can test
Painful arc - pain on shoulder abduction between 60 and 120 degrees
What is the mechanism of injury in rotator cuff tear?
Trauma
Repetitive activity
Overhead activity
Chronic degeneration
What are the features of rotator cuff tear?
Shoulder pain and weakness
Positive Neer’s, Hawkin’s and Gerber’s lift off tests
What is Neer’s test?
Pain during passive abduction of the arm with the scapula stabilised
What is Hawkin’s test?
The patient flexes the shoulder and elbow to 90 degrees
While supporting the patient’s arm at the elbow, the arm is internally rotated
Positive result - pain between 70 and 120 of internal rotation
What is the typical mechanism of injury in medial epicondylitis?
Repetitive use - golfer’s elbow
What are the features of medial epicondylitis?
Pain at the medial epicondyle
Pain radiates down the forearm
Pain on wrist flexion and pronation
Paraesthesia in the ulnar nerve distribution
What is the typical mechanism of injury in lateral epicondylitis?
Repetitive use - tennis elbow
What are the features of lateral epicondylitis?
Pain on resisted wrist extension
What are the features of De Quervain’s tenosynovitis?
Radial wrist pain (pain over the radial styloid process)
Pain on resisted thumb abduction
Finkelstein’s test positive
What is Finkelstein’s test?
The patient bends their thumb across the palm of their hand, makes a fist around it, and bends their wrist towards their pinky finger
Positive result - if there is pain on the thumb side of the wrist
What are the risk factors for Dupuytren’s contracture?
Increasing age
Family history
Male sex
Diabetes
Use of vibrating tools in manual labour
