Painful shoulder.

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Presentation transcript:

Painful shoulder

Referred pain synd. Cervical spondylosis Mediastinal pathology IHD

Joint disorder Glenohumeral arthritis Acromioclavicular arthritis

Bone lesion Infection Tumor

Rotator cuff disorder Tendinitis Rupture Frozen shoulder

instability Dislocation Sublaxation

Nerve inj. Suprascapular nerve entrapment

dis.of rotator cuff Muscles of rotator cuff 1.supraspinatus . 2.infraspinatus . 3.teres minor. 4.subscapularis.

Impingement synd. Rupture of rotator cuff. Acute calcific tendinitis Biceps tentinitis –rupture Adhesive capsulitis

Supraspinatus tendinitis is a painful dis. Which is thought to arise from repetitive compression or rubbing of tendons (mainly supraspinatous)under the corocoacromial arch. Normally when the arm is abd. ,the conjoint tendon slides under the corcoacromial arch. Other cause O.A of A.C joint

C.F Depend on Age Stage Healing resonse

Pattern of symptoms Subacute tentinitis (congestion,mic.heamorrage,odema) Pt. under 40 y . Ant. Shoulder pain after vigorius activity Shoulder look normal Tenderness in ant. Edge of acromian Point tenderness

Three test in diagnosis Painful arc Impingement sign Impingement test

Imaging X-ray normal in acute stage chronic (erosion,sclerosis,cystic lesion) in the site of cuff insertion 2.Arthrigrafy show partial or complete tear 3. U.S show large tear 4.MRI.show structure around shoulder

Treatment self limiting dis. Physiotherapy Start course of NSAID. Local injection

Surgical treatment Open acromioplasty Arthroscopic acromiopplasty Open repair of rotator cuff

Thank You