Arthrogenic Pathologies

Question 1

What are the arthrogenic shoulder pathologies?

Answer 1

• OA
• RA
• Frozen Shoulder
• ACJ Trauma
• Shoulder instability
• Traumatic dislocation

Arthrogenic pathologies are related to joint structures.

Question 2

What are the most common causes of stiffness in the shoulder?

Answer 2

• Frozen shoulder (adhesive capsulitis)
• Osteoarthritis (OA)
• Rheumatoid arthritis (RA)

OA in the GHJ is less common unless related to occupation or sport. RA is more common in the shoulder.

Question 3

True or false: Osteoarthritis (OA) in the shoulder is common.

Answer 3

FALSE

Shoulder OA is relatively rare compared to other joints.

Question 4

What are the risk factors for shoulder osteoarthritis (OA)?

Answer 4

• Age (> 65 years)
• Genetics
• Certain occupations (e.g., builders, overhead sports)

Prevalence of OA increases as the population ages.

Question 5

What distinguishes primary OA from secondary OA?

Answer 5

• Primary OA: Cause unknown
• Secondary OA: Has predisposing factors (e.g., trauma, dislocations, infection)

Secondary OA is influenced by previous injuries or conditions.

Question 6

What is frozen shoulder characterized by?

Answer 6

• Progressive loss of movement
• Pain caused by synovitis and fibrosis of the joint capsule

More common in patients aged 45-55, with a higher prevalence in females.

Question 7

How is frozen shoulder diagnosed?

Answer 7

Loss of 50% external rotation actively and passively with normal x-rays

Diagnosis is based on specific movement limitations.

Question 8

What are the three stages of frozen shoulder?

Answer 8

• Stage 1 (freezing): Reduction in ROM and increase in pain (2-9 months)
• Stage 2 (frozen): Reducing pain and plateauing stiffness (4-12 months)
• Stage 3 (thawing): Increasing ROM (12-24 months)

Frozen shoulder is self-limiting and often resolves without treatment.

Question 9

What treatment options are available for frozen shoulder?

Answer 9

• Physiotherapy
• Steroid injection
• Possibly surgery

Treatment aims to alleviate symptoms and improve mobility.

Question 10

What is the prevalence trend of shoulder osteoarthritis (OA)?

Answer 10

Increasing as the population ages

This trend is linked to the aging demographic.

Question 11

What is a rare but important condition to check for in shoulder injuries?

Answer 11

Missed posterior dislocation

It can occur from falls onto a flexed and internally rotated arm, or following seizures or electrocution.

Question 12

What are the three conditions associated with irritability?

Answer 12

• Acute tendinopathy
• Calcific tendinopathy
• Acute capsulitis / Frozen shoulder

These conditions are often evaluated to determine the source of shoulder pain.

Question 13

What are the types of instability related to shoulder conditions?

Answer 13

• Post dislocation instability
• Chronic multi-directional instability
• Scapulothoracic ‘instability’

These types of instability can affect shoulder function and require different management strategies.