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| ==X-ray Positive==
| | #REDIRECT[[Shoulder and upper arm diagnoses]] |
| # Dislocation | |
| # Fracture
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| # 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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| ###negFROM
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| ###slight 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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| #AC Injury, type 1 (see above)
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| #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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| #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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| ===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]] | |
