Podcast
Questions and Answers
What is the primary management for atraumatic or chronic anterior dislocations?
What is the primary management for atraumatic or chronic anterior dislocations?
- Observation and sling (correct)
- Steroid injections
- Immediate surgical intervention
- Physical therapy and rehabilitation
Which imaging technique is most commonly used to diagnose clavicular fractures?
Which imaging technique is most commonly used to diagnose clavicular fractures?
- Ultrasound
- MRI
- X-ray (correct)
- CT scan
What is the most common mechanism of injury for clavicular fractures?
What is the most common mechanism of injury for clavicular fractures?
- Twisting the arm during a fall
- Falling on an outstretched hand (correct)
- Direct blow to the shoulder
- Contact during sports activity
Which type of joint sprain involves elevation of the AC joint?
Which type of joint sprain involves elevation of the AC joint?
What describes a Bankart lesion?
What describes a Bankart lesion?
What is the most common type of sternoclavicular dislocation?
What is the most common type of sternoclavicular dislocation?
What is the typical treatment for a non-displaced sternoclavicular dislocation?
What is the typical treatment for a non-displaced sternoclavicular dislocation?
In the case of anterior sternoclavicular dislocation, what is a possible complication if left untreated?
In the case of anterior sternoclavicular dislocation, what is a possible complication if left untreated?
Which structure is at risk in posterior sternoclavicular dislocations?
Which structure is at risk in posterior sternoclavicular dislocations?
What is the commonly used imaging technique to assess sternoclavicular dislocation?
What is the commonly used imaging technique to assess sternoclavicular dislocation?
What type of fracture is associated with a Reverse Hill-Sachs Lesion?
What type of fracture is associated with a Reverse Hill-Sachs Lesion?
Which of the following ligaments is NOT associated with the acromioclavicular joint?
Which of the following ligaments is NOT associated with the acromioclavicular joint?
Which provocative test is NOT used to assess anterior instability?
Which provocative test is NOT used to assess anterior instability?
How long is the typical healing period for a sternoclavicular dislocation treated conservatively?
How long is the typical healing period for a sternoclavicular dislocation treated conservatively?
What is the mechanism of injury (MOI) commonly associated with anterior dislocations?
What is the mechanism of injury (MOI) commonly associated with anterior dislocations?
What is the percentage of sternoclavicular joint dislocations compared to all joint dislocations in the body?
What is the percentage of sternoclavicular joint dislocations compared to all joint dislocations in the body?
Which imaging view is specifically indicated for assessing Hill-Sachs lesions?
Which imaging view is specifically indicated for assessing Hill-Sachs lesions?
What does the Jerk Test assess?
What does the Jerk Test assess?
Which statement about dislocation is correct?
Which statement about dislocation is correct?
What should be avoided in rehabilitation concerning shoulder injuries?
What should be avoided in rehabilitation concerning shoulder injuries?
In which position does anterior subluxation most likely occur?
In which position does anterior subluxation most likely occur?
What is the primary cause of medial scapular winging?
What is the primary cause of medial scapular winging?
Which treatment is primarily recommended for children aged 3-8 years with nerve impairment due to scapular winging?
Which treatment is primarily recommended for children aged 3-8 years with nerve impairment due to scapular winging?
What is a common symptom observed in lateral scapular winging?
What is a common symptom observed in lateral scapular winging?
Which of the following is a typical clinical feature of snapping scapula syndrome?
Which of the following is a typical clinical feature of snapping scapula syndrome?
What kind of sound is associated with more severe conditions in snapping scapula syndrome?
What kind of sound is associated with more severe conditions in snapping scapula syndrome?
Which of the following treatments is often included in nonsurgical management of shoulder conditions?
Which of the following treatments is often included in nonsurgical management of shoulder conditions?
What demographic is primarily affected by proximal humeral head fractures?
What demographic is primarily affected by proximal humeral head fractures?
What might be a complication following surgery for shoulder injuries?
What might be a complication following surgery for shoulder injuries?
Which condition is characterized by pain, swelling, and ecchymosis in the upper arm after a fall?
Which condition is characterized by pain, swelling, and ecchymosis in the upper arm after a fall?
How is the sensation experienced if there is neurologic involvement in shoulder injuries?
How is the sensation experienced if there is neurologic involvement in shoulder injuries?
What is a common characteristic of Complex Regional Pain Syndrome?
What is a common characteristic of Complex Regional Pain Syndrome?
Which test is used to evaluate thoracic outlet syndrome?
Which test is used to evaluate thoracic outlet syndrome?
Which type of proximal humerus injury is characterized by C nerve involvement?
Which type of proximal humerus injury is characterized by C nerve involvement?
What percentage of all fractures are accounted for by proximal humerus injuries?
What percentage of all fractures are accounted for by proximal humerus injuries?
What is NOT a common treatment for thoracic outlet syndrome?
What is NOT a common treatment for thoracic outlet syndrome?
What is a primary symptom to assess in patients with thoracic outlet syndrome?
What is a primary symptom to assess in patients with thoracic outlet syndrome?
In which condition do sensory changes, trophic skin changes, and autonomic dysfunction appear?
In which condition do sensory changes, trophic skin changes, and autonomic dysfunction appear?
Which of the following symptoms is NOT related to thoracic outlet syndrome?
Which of the following symptoms is NOT related to thoracic outlet syndrome?
What is a common side effect of proximal humerus injuries in elderly patients?
What is a common side effect of proximal humerus injuries in elderly patients?
Which test would be inappropriate for diagnosing proximal humeral fractures?
Which test would be inappropriate for diagnosing proximal humeral fractures?
What is the main contributing factor to primary impingement of the shoulder?
What is the main contributing factor to primary impingement of the shoulder?
Which of the following exercises is NOT typically included in conservative treatment for shoulder conditions?
Which of the following exercises is NOT typically included in conservative treatment for shoulder conditions?
What imaging technique is considered the gold standard for diagnosing shoulder conditions?
What imaging technique is considered the gold standard for diagnosing shoulder conditions?
Which test is used to identify biceps tendon rupture?
Which test is used to identify biceps tendon rupture?
What is the most common cause of anterior shoulder pain related to primary impingement?
What is the most common cause of anterior shoulder pain related to primary impingement?
What is the clinical presentation of adhesive capsulitis?
What is the clinical presentation of adhesive capsulitis?
Which SLAP lesion type is characterized by a curved labrum?
Which SLAP lesion type is characterized by a curved labrum?
What is the primary goal of physical therapy in managing biceps tendonitis?
What is the primary goal of physical therapy in managing biceps tendonitis?
Which condition is most likely associated with scapular winging?
Which condition is most likely associated with scapular winging?
What is the typical age demographic for individuals most affected by adhesive capsulitis?
What is the typical age demographic for individuals most affected by adhesive capsulitis?
In the context of shoulder injuries, what does the term 'FOOSH' stand for?
In the context of shoulder injuries, what does the term 'FOOSH' stand for?
Which characteristic is NOT associated with calcific tendonitis of the supraspinatus tendon?
Which characteristic is NOT associated with calcific tendonitis of the supraspinatus tendon?
What is a common treatment modality for pain management in shoulder conditions?
What is a common treatment modality for pain management in shoulder conditions?
Which provocative test is specifically utilized to evaluate biceps tendon involvement?
Which provocative test is specifically utilized to evaluate biceps tendon involvement?
Flashcards
Anterior Sternoclavicular Dislocation
Anterior Sternoclavicular Dislocation
A type of shoulder joint dislocation where the medial end of the clavicle moves forward, commonly caused by direct trauma to the joint.
Posterior Sternoclavicular Dislocation
Posterior Sternoclavicular Dislocation
This is a type of shoulder joint dislocation where the medial end of the clavicle moves backward, often resulting in more severe pain and potential vascular problems.
Sternoclavicular Joint
Sternoclavicular Joint
This term refers to the joint formed between the clavicle and the sternum (breastbone).
Splint or Figure-of-Eight Bandage
Splint or Figure-of-Eight Bandage
A type of treatment used for sternoclavicular dislocations, where the shoulder is kept immobile for a period of time.
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Sternoclavicular Dislocation Surgery
Sternoclavicular Dislocation Surgery
A surgical procedure that may be necessary for sternoclavicular dislocations, especially when there is a large displacement or the clavicle sticks out prominently.
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Acromioclavicular Joint
Acromioclavicular Joint
This refers to the joint between the acromion (part of the shoulder blade) and the clavicle.
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Ligaments Supporting the Acromioclavicular Joint (3)
Ligaments Supporting the Acromioclavicular Joint (3)
These are the ligaments that support the acromioclavicular joint.
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Plain Radiographic Views of the Sternoclavicular Joint
Plain Radiographic Views of the Sternoclavicular Joint
X-rays taken from different angles to visualize the shoulder joint and assess the severity of the dislocation.
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AC Joint Sprain
AC Joint Sprain
A condition where the acromioclavicular joint is injured, causing pain and instability in the shoulder.
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Type 3-6 AC Joint Sprain
Type 3-6 AC Joint Sprain
A type of AC joint sprain where the acromioclavicular ligament is completely torn.
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Clavicular Fracture
Clavicular Fracture
A fracture that occurs in the collarbone, usually due to a fall directly onto the shoulder.
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Bankart Lesion
Bankart Lesion
A type of shoulder injury where the labrum, a ring of cartilage around the shoulder socket, is torn.
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AC Joint Impingement
AC Joint Impingement
A type of shoulder injury where the space between the shoulder blade and the collarbone is compressed, causing pain and limited movement.
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Reverse Hill-Sachs Lesion
Reverse Hill-Sachs Lesion
A compression fracture of the anteromedial aspect of the humeral head, often occurring with anterior shoulder dislocations.
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Apprehension Test
Apprehension Test
A test that provokes pain or instability in the shoulder by moving the arm into a position that stretches the anterior structures of the joint.
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Anterior Drawer Test
Anterior Drawer Test
A test to assess shoulder instability, where the humeral head is pulled forward to check for excessive movement.
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Jerk Test
Jerk Test
A test that assesses the integrity of the posterior structures of the shoulder joint by applying a posterior force to the humerus.
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Posterior Load and Shift Test
Posterior Load and Shift Test
A test used to assess potential shoulder instability by applying a posterior force to the humerus while the arm is abducted and externally rotated.
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Shoulder Subluxation
Shoulder Subluxation
Occurs when the humeral head partially slips out of the glenoid fossa, often causing a feeling of catching or instability.
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Shoulder Dislocation
Shoulder Dislocation
Complete separation of the humeral head from the glenoid fossa, causing significant pain and loss of function.
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D2 Flexion PNF Pattern
D2 Flexion PNF Pattern
This pattern of movement should generally be avoided after an anterior shoulder dislocation, as it can increase the risk of recurrence.
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Medial Scapular Winging
Medial Scapular Winging
A condition where the scapula (shoulder blade) fails to descend and develop normally, often due to weakness in the serratus anterior muscle caused by a long thoracic nerve injury.
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Lateral Scapular Winging
Lateral Scapular Winging
A condition where the scapula (shoulder blade) protrudes outward, usually because of weakness in the trapezius muscle due to an accessory nerve injury.
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Snapping Scapula Syndrome
Snapping Scapula Syndrome
A condition where the scapula rubs against the ribs, causing a 'popping' or 'grinding' sound, often associated with pain, weakness, and abnormal scapular movement.
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Proximal Humeral Head Fracture
Proximal Humeral Head Fracture
A break in the upper part of the humerus bone (the upper arm bone), typically occurring near the shoulder joint. Most common in elderly individuals due to falls or younger individuals due to high-energy trauma.
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Two-Part Surgical Neck Fracture
Two-Part Surgical Neck Fracture
A common type of proximal humeral head fracture that occurs in elderly individuals with osteoporosis, typically after a fall.
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Supraspinatus Inactivity
Supraspinatus Inactivity
A condition where the supraspinatus muscle, the primary abductor of the shoulder, becomes inactive, resulting in difficulty raising the arm. This can happen due to a fracture in the surgical neck of the humerus.
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Axillary Artery Injury
Axillary Artery Injury
A complication of proximal humeral head fractures that can occur due to injury to the axillary artery, which supplies blood to the shoulder and upper arm.
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Complex Regional Pain Syndrome (CRPS)
Complex Regional Pain Syndrome (CRPS)
A complex neuropathic pain syndrome characterized by intense pain, autonomic dysfunction, and potential contractures in the affected limb. Often caused by a nerve injury.
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Thoracic Outlet Syndrome
Thoracic Outlet Syndrome
A condition that affects the space between the clavicle and the first rib, causing pain, numbness, and weakness in the arm and hand.
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Scalenus Anticus Syndrome
Scalenus Anticus Syndrome
A type of Thoracic Outlet Syndrome that affects the space between the scalene muscles in the neck.
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Hyperabduction Syndrome
Hyperabduction Syndrome
A type of Thoracic Outlet Syndrome that happens in the space between the coracoid process and the pectoralis minor muscle.
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Costoclavicular Syndrome
Costoclavicular Syndrome
A type of Thoracic Outlet Syndrome affecting the space between the clavicle and the first rib.
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Halstead Test
Halstead Test
A test used to assess Thoracic Outlet Syndrome by checking for changes in blood flow and nerve function during arm positioning.
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Adson Test
Adson Test
This test assesses blood flow to the hand by compressing the subclavian artery at the clavicle.
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Wright Test
Wright Test
A test for Thoracic Outlet Syndrome that involves checking for changes in blood flow to the hand during arm positioning.
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Allen's Test
Allen's Test
A test for Thoracic Outlet Syndrome that involves raising the arm to a 90-degree angle and then checking for changes in blood flow and nerve function.
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Roos Test
Roos Test
A specific test for Thoracic Outlet Syndrome that involves performing various arm positions to assess for changes in blood flow and nerve function.
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Adhesive Capsulitis
Adhesive Capsulitis
A condition involving pain and restriction in shoulder movement, particularly flexion and abduction, caused by thickening and tightening of the shoulder joint capsule.
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SLAP Lesion
SLAP Lesion
A type of shoulder injury involving a tear of the superior labrum, the rim of cartilage around the shoulder socket, often at the site where the biceps tendon attaches.
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Scapular Winging
Scapular Winging
A condition where the shoulder blade (scapula) moves away from the rib cage, causing a wing-like appearance, usually due to weakness in the serratus anterior or trapezius muscles.
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Biceps Tendonitis
Biceps Tendonitis
The condition where the biceps tendon, particularly its long head, becomes inflamed, often seen in individuals over 40 with a history of impingement or rotator cuff tears.
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Biceps Tendon Rupture
Biceps Tendon Rupture
An injury where the biceps tendon tears, usually at the proximal end of the long head, causing possible sharp pain, snapping sensations, and a bulge in the lower arm.
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Calcific Tendonitis
Calcific Tendonitis
A condition where calcium deposits form in the shoulder tendons, most commonly in the supraspinatus tendon, causing sharp pain and difficulty with shoulder movement.
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Impingement Syndrome
Impingement Syndrome
A group of conditions involving compression of the tendons and bursa in the shoulder, often beneath the acromion bone, leading to pain and restricted movement.
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Hawkins-Kennedy Test
Hawkins-Kennedy Test
The test where the examiner internally rotates the shoulder and then brings the arm forward to assess for pain, potentially indicating impingement.
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Neer's Test
Neer's Test
The test where the examiner passively flexes the arm overhead, aiming to recreate pain, indicating possible impingement.
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Load and Shift Test
Load and Shift Test
A group of tests used to assess the stability of the shoulder joint by applying pressure and shifting the humeral head, detecting possible instability or laxity.
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O'Brien's Test
O'Brien's Test
A test used to assess shoulder instability by applying pressure to the arm in a specific position to see if the arm moves, typically indicating labral tears or instability.
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Anterior Glenohumeral Dislocation
Anterior Glenohumeral Dislocation
The most common type of shoulder dislocation, involving the displacement of the humerus (upper arm bone) out of the glenoid socket.
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Scapular Fracture
Scapular Fracture
A rare type of scapular fracture, often occurring alongside serious injuries, characterized by tenderness over the scapula and shoulder region.
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Sprengel Deformity
Sprengel Deformity
A congenital condition where the shoulder blade is abnormally high and positioned, resulting in a winged appearance and possible shoulder limitation.
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Rotator Cuff Tear
Rotator Cuff Tear
An injury causing a tear or rupture of the rotator cuff tendons, the group of muscles that stabilize the shoulder, potentially leading to significant pain and weakness.
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Sternoclavicular Dislocations
- More common (3 of all cases)
- Direct trauma to the SC joint
- Medial end of the clavicle becomes more prominent
- Mechanism of injury (MOI): High energy (MVA, contact sports)
- Posterior dislocations are less common, more painful, and more severe
- Vascular problems and risk to mediastinal structures are possible
- Breathing and swallowing difficulties are potential complications
- Note: Sternoclavicular (SC) joint dislocations account for less than 1% of joint dislocations overall
Acromioclavicular Joint Sprains
- Ligaments: Acromioclavicular, Coracoclavicular, and Coracoacromial ligaments
- Types of Sprains: Vary in severity from a stretched ligament (Grade 1) to a complete ligament rupture (Grade 6)
- Complete disruption of ligaments can result in posterior displacement of the distal clavicle
- Treatment varies from observation/sling to surgical intervention depending on the severity
Clavicular Fractures
- Fractures based on location (medial, distal third)
- MOI (Mechanism of Injury): Fall on outstretched hand (FOOSH) or Fall on Shoulder (FOS)
- Diagnosis via X-Ray
- Age: Predominantly under 25 years old
Glenohumeral Joint (GHJ) Injuries
- Subluxation: Humeral head displacement on the glenoid fossa
- Dislocation: Complete separation of the humeral head from the glenoid fossa.
- Anterior dislocations are more common than posterior dislocations
- Common MOI: Abduction and external rotation
- Possible associated injuries: Axillary nerve traction, Bankart lesion, Hill-Sachs lesion, and Reverse Bankart and Hill-Sachs lesion
Impingement Syndrome and Rotator Cuff Tears
- Common cause of shoulder pain
- Impingement involves compression of the rotator cuff tendons and bursa between the humeral head and acromion.
- Supraspinatus tendon is the most commonly implicated tendon -Elderly often experience rotator cuff tears—either partial or full-thickness
Glenoid Labrum Tears
- Cartilage (labrum) that deepens the glenoid fossa
- Injuries: Can involve rotator cuff and biceps tendons
- Common tear location: Superior Labrum Anterior-Posterior (SLAP) lesion, at the bicep tendon attachment point
Degenerative Joint Disease of the Shoulder (Osteoarthritis)
- Narrowing of the glenohumeral joint space
- Cartilage destruction
- May involve the glenohumeral or acromioclavicular (AC) joints
Biceps Tendon Ruptures
- Injury to the long head of biceps brachii tendon
- Seen in individuals over 40 years old, often with a history of shoulder impingement
Calcific Tendonitis of the Supraspinatus Tendon
- Calcium deposits (Hydroxyapatite) in the supraspinatus tendon
- Idiopathic, more common in supraspinatus
- Most often accompanied by pain and restricted shoulder range of motion
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