painful shoulder

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