Shoulder and Elbow Problems Flashcards Preview

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Flashcards in Shoulder and Elbow Problems Deck (27)
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1
Q

What are the most common shoulder problems in the following populations:

  • Teens/20s
  • 30s/40s
  • 50s/60s
  • 70s+
A
  • Teens/20s = fractures and instabilities
  • 30s/40s = rotator cuff injuries and capsulitis
  • 50s/60s = impingement and acromioclavicular joint problems
  • 70s+ = degenerative rotator cuff and joint problems
2
Q

What are the most common causes of upper limb fractures?

A

Young population, high energy injuries

Elderly osteoporotic injuries

3
Q

What factors affect management of upper limb fractures?

A

Fracture configuration

Patient biology

4
Q

What joint is most commonly dislocated and why?

A

The shoulder joint as it is the most mobile joint in the body

5
Q

What populations do shoulder dislocations occur in?

A

Most commonly teenagers

Elderly

6
Q

What proportion of shoulder dislocations are anterior, posterior and inferior?

A

Anterior- 90%
Posterior- 9%
Inferior- 1%

7
Q

What extra management steps need to be taken in cases of posterior shoulder dislocations?

A

Check for epilepsy or electrocution as seizures are the most common cause of posterior dislocations

8
Q

What are the complications of teenage shoulder dislocation and why?

A

Recurrent dislocations are almost definite as the labrum is commonly torn in teenage dislocations. This is known as a Bankart tear.

9
Q

What are the steps in management of shoulder dislocation?

A

Manipulation of shoulder back into socket
Immobilisation with a sling for a few weeks to reduce pain and inflammation
Physiotherapy
Surgery in some cases

10
Q

What population is most commonly affected by subacromial impingement?

A

30s/40s

11
Q

What pathophysiological process causes frozen shoulder and how does it manifest?

A

Inflammation of the capsule between the ball and the socket, manifesting as painful restriction of shoulder movement

12
Q

How is diagnosis of frozen shoulder done?

A

Clinically- unilateral global restriction of shoulder movement

13
Q

What investigation can confirm diagnosis of frozen shoulder and what conditions can mimic it clinically?

A

X-ray

Dislocated shoulder and shoulder arthritis

14
Q

What pathological processes can cause subacromial impingement and how does this manifest?

A

Narrowing of the subacromial space due to either a decreased volume of the subacromial space or an increase in the volume of the contents of the subacromial space. This presents as pain that is present when the shoulder is abducted.

15
Q

How is subacromial impingement managed?

A

Ultrasound guided injection of subacromial steroid and physiotherapy.
In some cases arthroscopic subacromial decompression surgery can also be used

16
Q

What are the causes of frozen shoulder?

A

Idiopathic
Trauma
Other disease

17
Q

How is frozen shoulder managed?

A

If the disease presents early then hydrodilatation can be curative
If the disease doesn’t present until later then surgery may be required

18
Q

What are the causes of rotator cuff tears?

A

Trauma

Degenerative

19
Q

When do rotator cuff tears require surgery?

A

Acute tears in otherwise healthy individuals
Chronic tears that are symptomatic
Treatment also depends on size of tear, time of injury and age/biology of patient

20
Q

How are rotator cuff tears that have missed the chance for normal repair repaired?

A

Superior capsular reconstruction

21
Q

What is the best view for x-raying shoulder arthritis?

A

Axillary view

22
Q

How is shoulder arthritis managed?

A

If the rotator cuff is attached then a standard shoulder replacement can be done, otherwise a reverse should replacement is necessary

23
Q

What are the common elbow problems in different ages?

A

Young- fractures and dislocations
Middle aged- tedinopathies
Elderly - degenerative diseases
Any age- cubital tunnel syndrome

24
Q

What are the common tendinopathies affecting the elbow and what is the difference between them?

A

Golfers elbow and tennis elbow

Golfers elbow affects medial side of elbow, tennis elbow affects lateral side

25
Q

What kind of condition are tendinopathies?

A

Degenerative

26
Q

How are tendinopathies treated?

A

Injection of platelet rich plasma into the elbow joint

27
Q

Compression of what nerve causes cubital tunnel syndrome?

A

The ulnar nerve