Shoulder Mobility Deficits Diagnosis Quiz

o The text discusses potential diagnoses and interventions for shoulder pain, focusing on conditions such as Glenohumeral Osteoarthritis (GHOA), Rotator Cuff Tendinopathy, Labral Injuries, and Instability.

o GHOA: Patient may have history of overhead throwing, insidious onset of symptoms, morning stiffness, pain with activity, and crepitus. Objective findings include decreased ROM, bony enlargement, joint effusion, and decreased joint mobility. Interventions include MRI diagnosis, physical therapy focusing on joint mobilization, muscle length, and functional loading, and medical interventions such as NSAIDs, hyaluronic acid injections, corticosteroid injections, and surgery.

o Rotator Cuff Tendinopathy: Consider middle-aged patients with pain at top and lateral aspect of the shoulder, weakness with or without pain during lifting or overhead activities, history of repetitive overhead activity or prior trauma. Objective findings include pain with overhead elevation, tenderness over rotator cuff, and decreased muscle performance. Interventions include physical therapy focusing on tissue tolerance, force production, and normalizing movement, as well as medical interventions such as oral anti-inflammatories and corticosteroid injections.

o Labral Injuries (SLAP Tears): Consider patients who are current or prior throwing athletes, have suffered a FOOSH, or have recently experienced forceful arm traction. There are different types of SLAP tears, including Type I, II, III, IV, and complex. Objective findings include decreased overhead ROM, pain with biceps contraction and heavy lifting, and joint instability. Interventions include physical therapy focusing on coordination and activation of muscles, dynamic joint stability, weightbearing activities, and normalizing movement, as well as medical interventions such as surgical repair.

o Glenohumeral Instability (Traumatic or Atraumatic): Consider patients with sudden onset of symptoms with or without trauma, participation in contact sports, or generalized joint hypermobility. Objective findings include decreased ROM, decreased dynamic mobility control, and hypermobility of the joint. Interventions include physical therapy focusing on coordination and activation of muscles, weightbearing activities, and normalizing movement, as well as medical interventions such as surgical repair.

o Outcome measures for all conditions include the Patient Specific Functional Scale (PSFS), QuickDASH, and Penn Shoulder Scale (PSS).

o No Current CPG for diagnosis or intervention of Biceps Load Test for SLAP Tears.

o Referral for further diagnostic testing or surgical intervention may be necessary.