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Department of Traumatology and Hand Surgery University of Medical Sciences in Poznan Head of Department: Prof. Władysław Manikowski Head of Department:

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Presentation on theme: "Department of Traumatology and Hand Surgery University of Medical Sciences in Poznan Head of Department: Prof. Władysław Manikowski Head of Department:"— Presentation transcript:

1 Department of Traumatology and Hand Surgery University of Medical Sciences in Poznan Head of Department: Prof. Władysław Manikowski Head of Department: Prof. Władysław Manikowski Przemysław Lubiatowski MD, PhD

2 Upper Extremity Examination

3 Taking history Physical examination Taking history Physical examination EXAMINATIONEXAMINATION

4 Taking history Knowledge of the disease process Main complaints (pain) Onset, Duration Dominant hand Prior therapy Knowledge of the disease process Main complaints (pain) Onset, Duration Dominant hand Prior therapy EXAMINATIONEXAMINATION

5 Physical examination Look Feel Move X-ray Look Feel Move X-ray EXAMINATIONEXAMINATION

6 Main complaint -pain -instability -stiffness, limitation of ROM, snapping, crepitation Age > 70 y.o. < 30 y.o. Onset of symptoms Treatment Main complaint -pain -instability -stiffness, limitation of ROM, snapping, crepitation Age > 70 y.o. < 30 y.o. Onset of symptoms Treatment Rotator cuff tear instability HISTORYHISTORY

7 Main complaint -pain -instability -stiffness, limitation of ROM, snapping, crepitation Age > 70 y.o. < 30 y.o. Onset of symptoms Treatment Main complaint -pain -instability -stiffness, limitation of ROM, snapping, crepitation Age > 70 y.o. < 30 y.o. Onset of symptoms Treatment Rotator cuff tear instability HISTORYHISTORY

8 Main complaint -pain -instability -stiffness, limitation of ROM, snapping, crepitation Age > 70 y.o. < 30 y.o. Onset of symptoms Treatment Main complaint -pain -instability -stiffness, limitation of ROM, snapping, crepitation Age > 70 y.o. < 30 y.o. Onset of symptoms Treatment Rotator cuff tear instability HISTORYHISTORY

9 Evaluation systems specific -Simple Shoulder Test -UCLA -ASES general health -SF-36 Evaluation systems specific -Simple Shoulder Test -UCLA -ASES general health -SF-36 HISTORYHISTORY

10 Pain ac. to ASES Pain ac. to ASES HISTORYHISTORY Do you have pain in your shoulder ?Yesno Mark location of pain Do you have pain at night ?yesno Do you take pain killers ?yesno Do you take narcotic drugs ?Yesno How many tablets per day ?Quantity How severe is you pain ? noas severe as possible 010

11 Instability ac. to ASES Instability ac. to ASES Do you have feeling of instability ? (as if your shoulder would drop of) YesNo How unstable is your shoulder (mark the line) ?very stableunstable 010 HISTORYHISTORY

12 Look Palpation Look Palpation PHYSICAL EXAMINATION

13 Range of motion PHYSICAL EXAMINATION

14 Range of motion

15 PHYSICAL EXAMINATION Range of motion

16 0 0 –1 cm cm > 2 cm Instabilitydrawer test -anterior -sitting, laying Instabilitydrawer test -anterior -sitting, laying PHYSICAL EXAMINATION

17 Instabilitysulcus sign -sitting, laying Instabilitysulcus sign -sitting, laying PHYSICAL EXAMINATION

18 Instability Evaluation under anesthesia Instability Evaluation under anesthesia PHYSICAL EXAMINATION

19 Instability (apprehension test) -sitting, laying Instability (apprehension test) -sitting, laying PHYSICAL EXAMINATION

20 Instability (relocation test) -sitting, laying Instability (relocation test) -sitting, laying PHYSICAL EXAMINATION

21 Impingement syndrome Neers Test Impingement syndrome Neers Test PHYSICAL EXAMINATION

22 Impingement syndrome Hawkins Test Impingement syndrome Hawkins Test PHYSICAL EXAMINATION

23 Impingement syndrome Painful arch test Impingement syndrome Painful arch test PHYSICAL EXAMINATION lidocaine Test with lidocaine

24 Impingement syndrome (biceps brachii) Yergasons Test Speed Test Impingement syndrome (biceps brachii) Yergasons Test Speed Test PHYSICAL EXAMINATION


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