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Orthopedic Pathologies of the shoulder

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Differential Diagnosis
Signs and Symptoms
Tendonitis   overuse injury, inflammation of a tendon, dull/chronic P!, weakness, sensitive to palpation, passive stretching discomfort through ROM  
Shoulder Pointer   most common on tip of shoulder or AC jt, a contusion w/out ligament injury  
Blockers Spur   repeated blows to the deltiod, bone spurs formation  
Biceps strain   swelling, pt tenderness in the bicepital groove, loss ROM, may have discoloration  
Inferior GH Sprain   from forced add/internal rotation, radiating P to top shoulder, head humerus in axilla, flattened delt, prominent coracoid/acromion process, pt tender  
Impingement Syndrome   affects rotator cuff, overuse injury, swelling, P! while sleeping, shoulder feels weak, bursitis as a result of pinching in acromion, pt tenderness  
Tenosynovitis   inflammation of the sheath surrounds the tendons, dificult ROM, P and pt tenderness around jt, swelling, stiffness  
AC Sprain   results FOOSH, pain, crepitus, visual deformity, +O'Briens, AC sheer, Sulcus, need to r/o impingement  
Glenohumeral Anterior Sprain   arm forced into abd/ext rotation, direct blow, P/decreased ROM, pt tenderness, relief with reduction, may have numbness/tingling  
Posterior GH Sprain   rare, caused by forced abd, may cause the arm to be above head and unable to bring in down  
Glenohumeral subluxation   incomplete dislocation, dead arm syndrome, pt tenderness, weakness, crepitus, + apprehension/relocation tests/impingement test, flattened shoulder, stabbing P, mm guarding, poor ROM, swelling  
SC sprain   posterior very severe, FOOSH injury, direct trauma, pt tenderness, swelling, deformity, ant/med clavicular promerence, loss function/ROM, P with breathing  
Labrum Tears: Bankart   usually w/ subluxation/dislocation, clicking/popping, P with any GH ROM, + clunk test, avulsion/damage to the ant lip of labrum from humerus slided forward ant. dislocation  
Labrum Tears: SLAP lesion   clicking/popping, P with any GH ROM, + clunk test, sup labrum-ant to post, disrupting the longhead of biceps tendon attachment  
Hill-Sachs deformity   associated with GH dislocations, repetitive impact, P, pt tenderness, swelling  
Scapula Fx   very rare, swelling, pt tenderness, avulsion coracoid process, direct trauma, discoloration  
Humeral head Fx   violet direct trauma, FOOSH, may resemble dislocation, P, pt tender, deformity, swelling, supporting arm, mm spasm, deceased ROM, may have compromised circ/neuro  
Clavical Fx   80% mid-shaft, direct trauma/FOOSH, P, pt tender, crepitus, deformity, swelling, bruising, +percussion/sheer, loss ROM  
Multidirectional instability   "looseness" of shoulder w/ multiple directions, P, imflammation, irritation  
Brachial Plexus injury   lat flex of head, numbness/burning, P in neck/shoulder, parethesia, mm weakness, swelling, loss circulation/neuro/sensation/ROM  
Thoracic Outlet Syndrome   compression brachial plexus, cold sensitivity, palor appearance, distal swelling, numbness/tingling, Neuro problems, aching P in neck/shoulder/down arm  
Adhesive Capsulitis "Frozen Shoulder"   inflammation about rotator cuff/capsular area, P!, loss ROM, idiopathic  
Subacromial Bursitis   direct trauma, swelling, pt tenderness, localized heat, P around area, usually accompanied by other injuries  


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Created by: ATskg on 2007-07-07

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