Questions and Answers
What is a Bankart lesion?
What does a Reverse Bankart lesion involve?
Which condition is associated with mobility deficits?
What are the typical symptoms of Adhesive Capsulitis?
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What is a common symptom observed in patients over 60 with GHJ Primary OA?
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What is typically reported by patients with Rotator Cuff tears?
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What does SLAP stand for in shoulder injuries?
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AC joint injury special tests combine pain with palpation and a positive ______ active compression test.
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What is a negative finding to rule out subacromial pain syndrome?
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What is the treatment recommendation for subacromial pain syndrome?
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What does a Full-thickness RTC tear present with?
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What is the typical outcome for patients undergoing surgical treatment for persistent subacromial pain?
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What is a key finding to rule in Primary Adhesive Capsulitis?
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Study Notes
Shoulder Pathologies and Lesions
- Bankart Lesion: Involves avulsion of anterior glenoid and anterior inferior glenohumeral ligaments; associated with risk of instability recurrence post-repair if bony lesions are ignored.
- Reverse Bankart Lesion: Capsulolabral injury involving the posterior labrum; can also present as a bony reverse Bankart lesion.
ICF Classifications for Shoulder Disorders
- Mobility Deficits: Seen in conditions like adhesive capsulitis.
- Muscle Performance Deficits: Associated with subacromial pain syndrome and SLAP tears.
- Motor Coordination Deficits: Related to shoulder instability.
Specific Conditions
- Adhesive Capsulitis (Frozen Shoulder): Characterized by anterior-lateral shoulder pain, sleep disruptions, and gradual motion loss; higher risk in females aged 40-65, especially those with diabetes or hypothyroidism.
- Glenohumeral Joint Primary Osteoarthritis: Gradual pain onset and motion loss; commonly affects individuals aged 60+ with symptoms like crepitus and morning stiffness.
- Subacromial Pain Syndrome: Pain occurring with arm elevation, catching, and stiffness, typically seen in individuals aged 60+.
- Rotator Cuff Tear: Presents similarly to other shoulder disorders; patients notice pain and loss of shoulder motion.
Instabilities and Tears
- Anterior Instability/Labral Tear: Symptoms include pain, apprehension in abduction/external rotation, history of trauma, recurrent subluxations, and joint clicking.
- Posterior Instability: Displays similar symptoms to anterior instability, with joint locking and historical trauma reports.
Lesions and Impingements
- SLAP Lesions: Characterized by deep anterior shoulder pain with clicking or locking during throwing activities.
- Posterior Internal Impingement: Pain during abduction and external rotation, often in overhead athletes with reported performance impairments.
- Long Head of Biceps Tendinopathy: Anterior bicipital groove pain linked to positions involving shoulder flexion and arm supination.
AC Joint Pathologies
- AC Joint Pain/Arthropathy: Pain at the AC joint worsening with arm elevation and horizontal adduction; may involve trauma history and present with visual shoulder deformity.
Diagnostic Criteria
- SAIS Positive Findings: Includes positive impingement tests (Neer, Hawkins, Jobe), painful arc, and resisted external rotation pain; strong indicators for impingement syndrome.
- SAIS Negative Findings: Significant loss of passive range of motion (PROM) and apprehension with instability tests indicate different pathologies.
- Rotator Cuff Tear Indicators: Age >60, presence of lag signs, weakness, and atrophy are substantial predictive factors.
Adhesive Capsulitis Management
- Primary Adhesive Capsulitis: Characterized by spontaneous pain and restricted motion, especially external rotation; responds well to intra-articular steroid injections and physical therapy interventions.
- Stages of Symptoms: Continuum includes pre-freezing, freezing, frozen, and thawing stages, typically lasting around 18 months.
Subacromial Pain Syndrome Management
- Intervention: Exercise is preferred for improvement in pain and function, emphasizing rotator cuff strengthening and mobility enhancements.
- Manual Therapy: Recommended to complement exercise for pain modulation and muscle activity improvement.
Surgical Options
- Subacromial Decompression: Meta-analysis suggests no significant advantage over physical therapy for persistent subacromial pain; arthroscopic procedures favored over bursectomy for patient outcomes.
- Full-Thickness Rotator Cuff Tear Management: Depends on tear size; small/medium tears prioritized for non-surgical management, while large/massive tears often require surgical intervention.
Overall Insights
- Regular assessments of shoulder function and stability are crucial in guiding appropriate treatment plans, including the potential need for surgical consultation in cases of major rotator cuff tears or persistent symptoms.
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Description
This quiz contains flashcards focused on important shoulder injuries including Bankart and Reverse Bankart lesions. Each term is defined to enhance your understanding of these common orthopedic issues. Perfect for medical students and professionals in the field of orthopedics.
