Week 5 - Shoulder Flashcards
describe impingment syndrome
pain occurs as the inflamed part of a rotator cuff tendon passes through the tight subacromial space. Cuff muscle is mostly supraspinatus
several causes of tendon/ space inflammation
May have radiating pain to deltoid and upper arm
4 ways that impingment syndrome may occur
Tendonitis
Subacromial bursitis
Acromioclavicular OA osteophyte
Hooked cuff tear
2 tests that show pain in impingement syndrome?
- painful arc
2. Hawkin’s Kennedy
treatment of impingment syndrome?
conservative - NSAIDS, analgesia, physio
up to 3 corticosteroid injections
Subacromial decompression surgery - open or closed options
classic history of a cuff tear
- who
- how?
grey hair = Cuff tear
People over 40 years old
usually a “sudden jerk” - miminal trauma but have degenerated tendons
what rotator cuff muscle is most likely to tear?
Supraspinatus
Large tears extend into sup and infra
What imaging is done for rotator cuff tears? (2)
Ultrasound or MRI
treatment options for rotator cuff tears?
- physio +/- injections
2. surgical repain with subacromial decompression. tricky
describe frozen shoulder (adhesive capsulitis)
pain first
then stiffness
less pain
stiffness thaws out by 2 years
who gets frozen shoulder?
age 40-60
triggering injury
shoulder surgery
diabetics
treatment of frozen shoulder?
physio
Analgesia
+/- steroid injections when painful
if still stiff = MUA or surgical capsular release
Acute onset severe shoulder pain, greatly relieved with subacromial steroids + anaesthetic injection… what is it?
Acute Calcific Tendonitis
deposits on the supraspinatus tendon
self limiting
less pain as calcification resolved
referred pain to the shoulder - where from?
- neck
- angina
- diaphragm irritation eg. biliary colic or an abscess
