Shoulder

Question 1

• Male, 20-30
• Increased activity (sport/work)
• Ant Shoulder pain which may radiate
  down anterior arm
• (-) Overhead activity
• Neuro = wnl

Answer 1

Biceps Tendonitis

(+): Speed’s, Yerguson’s

Question 2

• Male, 25-40
• Gradual onset pain (mech unclear)
• (-) arm abduction/overhead activities
• AROM - limited > 80
• Tests (x4)

Answer 2

Impingement Syndrome

(+): Hawkins-Kennedy, Neer’s Test
RC (Empty Can)

Question 3

• F (2:1), 40-60
• RF: Age, post -surgical/traumatic
• Pain sleeping, loss ADL’s
• Loss A + PROM (Ex Rot = worse)
• pain + capsular end-feel
• May be self resolving

Answer 3

• Frozen shoulder syndrome

(+): External Rotation, Apley’ scratch

Question 4

• Local pain + tenderness
• +/- Swelling
• (-) Sleeping, overhead activities
• (+) Rest
• RF: Old ( Gout, RA, DM), Young (trauma)

Answer 4

Bursitis

Question 5

• M (5:1), 15-25
• Pain post traumatic (FOOSH)
• (-) A+PROM Abd >90
• +/- swelling
• Myospasm: delt, trap +/or lev scap

Answer 5

AC Sprain

(+) Obrien’s, AC shear
* Delts + Traps = stabilizers

Question 6

• 15-30, F
• (-) overhead carrying
• A + PROM - Clunk or apprehension
  with Abd + ER

Answer 6

Anterior shoulder Instability

(+) Anterior Apprehension Test
* RC = Stabilizers

Question 7

Patient presents with signs + symptoms of shoulder Instability/ dislocation injury. What do you need to confirm before you can send for x-ray?

Answer 7

At least one:
- > 40
- 1st ever dislocation
- Traumatic MOI

Question 8

• m.c cause of shoulder pain (30%)
• Repetitive stress (overhead / pulling)
• movement related pain
• Pain and weakness Abd/ER/IR
• Pain is dull + gradual onset
• May radiate down lateral arm

Answer 8

RC sprain

Tests:
Painful arc
Empty can - SupraS.
Hawkins Kennedy - SupraS
Neer - Supraspinatus
ER (zero) - InfraS
ER (90) - Teres Minor
Lift off/Beer hug/Belly press - SubS
ER lag sign - full tear SupraS / InfraS