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| ==X-ray Positive==
| | #REDIRECT[[Shoulder and upper arm diagnoses]] |
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| 0. Dislocation
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| 1. Fracture
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| 2. AC Injury
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| Injury: Direct trauma, chronic
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| Diag: Superior pain; pain adduction
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| TypexxExam
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| 1negFROM
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| 2slight displace
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| 3100% displaceclinc deform
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| Rx:
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| 1&2 --> sling, PMD, ROM ex after 2wks
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| 3 --> sling, ortho x 2 dys, ?surg
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| ==X-ray Negativie==
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| 1. AC Injury, type 1 (see above)
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| 2. Glenohumeral Instability
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| -subluxation (separation) or dislocation (now reduced)
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| -PE: pt holds arm close to body with unaffected hand
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| Rx: F/U ortho
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| 3. Rotator Cuff
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| Injury: 90% chronic arms overhead
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| Diag:
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| -result of extreme overuse in young adults (e.g. pitchers) or minor trauma in older adults
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| -sudden "pop" while lifting overhead
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| -lateral pain
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| -worse at night
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| -abduct arm pain after 20deg
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| -relief of pain w/ lido inject
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| (pain free weakness = full tear)
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| PE: -loss of active BUT NOT passive ROM (due to pain)
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| -positive impingement signs
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| -weakness with drop arm test
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| Rx: Acute --> sling, PT, ortho f/u
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| Chronic --> PT, ortho
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| Next: MRI, surgery for younger pts with big tear, rehab
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| PT: arm dangle at side, circle 5-10wt
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| 4. Biceps Tendon Rupture
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| -bulge in distal humerus (Popeye muscle), usually result of injury
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| -PE: 20% loss of strength of supinators, 8% loss of strength of elbow flexors
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| -next: surgery for younger pts, rehab
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| ==Source==
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| 8/07 DONALDSON (adapted from Miller, Mistry)
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| [[Category:Ortho]] | |
