Presentation on theme: "Page 1 The Shoulder in General Practice Mr T P Selvan MB, LRCP, FRCS Ed, MSc (Ortho), FRCS (Ortho) Consultant Orthopaedic Surgeon East Surrey Hospital,"— Presentation transcript:
Page 1 The Shoulder in General Practice Mr T P Selvan MB, LRCP, FRCS Ed, MSc (Ortho), FRCS (Ortho) Consultant Orthopaedic Surgeon East Surrey Hospital, Redhill.
Page 2 Know the Anatomy Examine Clinically & Look For Diagnostic Clues Investigate Identify the Red flags Treat Refer to Specialist Scope
Page 12 Clinical Examination Look Feel Move!!! Range of movement. Deltoid function. Tests for Supraspinatus function. Tests for Infraspinatus / Teres minor function. Tests for subscapularis function. Tests for Biceps Tendon Tests for ACJ and Superior labrum.
Page 13 Movements
Page 14 Supraspinatus
Page 15 Infraspinatus / Teres minor
Page 16 Obriens test for ACJ/Slap Lesion
Page 17 Gerbers Lift off for subscapularis
Page 18 Belly Press for Subscapularis
Page 19 Neers Test
Page 20 Hawkins-Kennedy test
Page 21 Biceps tendon-Speed test
Page 22 Apprehension Tests ApprehensionRelocation Test Sulcus Test Drawers tets
Page 38 Indications for Injection Diagnostic –Subacromial impingement –AC joint pain –Aspiration Therapeutic –Subacromial impingement –Rotator cuff tendinitis / Bursitis –Calcific tendinitis –Glenohumeral OA –Long head of biceps tendinitis –Frozen Shoulder –AC joint arthritis
Page 40 When to Refer to a Shoulder Specialist Impingement not responding to conservative measures Frozen shoulder not showing any improvement despite physiotherapy for 6 months Suspected Rotator cuff tear. Cuff tear arthropathy Instability / SLAP lesions Osteoarthritis / Rheumatoid Arthritis Uncertainty of diagnosis. Red flag signs
Page 41 Infection: red hot skin, pyrexial, systemically unwell Unreduced dislocation: h/o trauma/fit/electric shock, abnormal contour, loss of movements Acute rotator cuff tear: acute onset pain and weakness, recent trauma, drop arm sign Tumour: S/S of cancer, h/o cancer, abnormal mass, swelling or deformity Neurological: severe sensori-motor deficit, unexplained muscle wasting.