Shoulder Conditions Notes

Shoulder conditions

Shoulder pain location

Pain felt at the;

ACJ The shoulder joint itself

Deltoid Rotator cuff

Globally Degeneration

Stabilisers of shoulder

Static

• Superior, middle and inferior glenohumeral ligaments

• Coracohumeral ligament

Active

• Rotator cuff

• Long head of biceps

• Scapular muscles

Shoulder dislocation

Anterior

- Due to forced abduction, extension and external rotation

• Loss of shoulder contour (flattening of deltoid)

• Anterior bulge of head of huumerus (palpated in axilla)

Investigations

• AP + axial/lateral scapular views on xray

Management

• Reduction

Complications

• Hills-sachs lesion

  • Depression of posterior-superior humeral head due to repeated impact with the anterior rim of glenoid

• Bankhart lesion

  • Separation of labrum and capsule from anterior rim of glenoid

• Axillary nerve damage

  • Feel sensation over regimental badge region

Posterior dislocation

• Very rare

• Due to forced flexion, abduction and internal rotation

  • Electrocution/epileptic fit

• Lightbulb sign on xray (can get reverse Hills-sachs)

Impingement syndrome

Chronic tendonitis of rotator cuff muscles due to;

• Overuse

• Minor tears

• Osteophyte formation

Can all cause impingement of the supraspinatous tendon under the acromion

Occurs in patients 40-60yrs

Presents with pain (not necessarily painful arc)

Examination

• Painful arc

• Empty can test

• Hawkins

• Neers

Investigations

• Xray

  • Can show calcification of tendon or osteophyte formation

• Ultrasound/MRI

  • Cuff tears, tendon tears, bursitis

Management

• Physio

• Analgesia – steroid injection

• Surgical decompression

Frozen shoulder/adhesive capsulitis

Inflammation of connective tissue around the capsule

Affects patients 40-60 yrs often with history of mild trauma

Presentation = Progressive severe pain followed by stiffness

Patients at risk = diabetics, RA, lung disease, heart disease, previous stroke

Examination

• Decreased active and...

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