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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  
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Shoulder Pointer   most common on tip of shoulder or AC jt, a contusion w/out ligament injury  
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Blockers Spur   repeated blows to the deltiod, bone spurs formation  
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Biceps strain   swelling, pt tenderness in the bicepital groove, loss ROM, may have discoloration  
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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  
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Impingement Syndrome   affects rotator cuff, overuse injury, swelling, P! while sleeping, shoulder feels weak, bursitis as a result of pinching in acromion, pt tenderness  
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Tenosynovitis   inflammation of the sheath surrounds the tendons, dificult ROM, P and pt tenderness around jt, swelling, stiffness  
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AC Sprain   results FOOSH, pain, crepitus, visual deformity, +O'Briens, AC sheer, Sulcus, need to r/o impingement  
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Glenohumeral Anterior Sprain   arm forced into abd/ext rotation, direct blow, P/decreased ROM, pt tenderness, relief with reduction, may have numbness/tingling  
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Posterior GH Sprain   rare, caused by forced abd, may cause the arm to be above head and unable to bring in down  
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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  
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SC sprain   posterior very severe, FOOSH injury, direct trauma, pt tenderness, swelling, deformity, ant/med clavicular promerence, loss function/ROM, P with breathing  
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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  
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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  
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Hill-Sachs deformity   associated with GH dislocations, repetitive impact, P, pt tenderness, swelling  
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Scapula Fx   very rare, swelling, pt tenderness, avulsion coracoid process, direct trauma, discoloration  
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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  
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Clavical Fx   80% mid-shaft, direct trauma/FOOSH, P, pt tender, crepitus, deformity, swelling, bruising, +percussion/sheer, loss ROM  
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Multidirectional instability   "looseness" of shoulder w/ multiple directions, P, imflammation, irritation  
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Brachial Plexus injury   lat flex of head, numbness/burning, P in neck/shoulder, parethesia, mm weakness, swelling, loss circulation/neuro/sensation/ROM  
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Thoracic Outlet Syndrome   compression brachial plexus, cold sensitivity, palor appearance, distal swelling, numbness/tingling, Neuro problems, aching P in neck/shoulder/down arm  
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Adhesive Capsulitis "Frozen Shoulder"   inflammation about rotator cuff/capsular area, P!, loss ROM, idiopathic  
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Subacromial Bursitis   direct trauma, swelling, pt tenderness, localized heat, P around area, usually accompanied by other injuries  
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