1. . Mr Lee Van Rensburg January 2014

2. .  6 week history  Pain upper arm  Rest 1-2/10  Occasion (stresses it) 4/10  Started after weekend gardening  Desk top job  Unable to play squash/ tennis  Pain on putting on jacket  Sleeping OK  Rx Nothing (doesn’t like tablets)

3. .  Supraspinatus tendonitis  Subacromial bursitis  Treatment  EDUCATION  Zone impingement  Week end warrior  Paint and decorate like professional  Relative rest / time  NSAID  Physiotherapy  Injection?  Surgery ???

4. .  1 YR shoulder problems on and off  Pain when plays sport exerts himself, radiating down arm  Ache 4-5/10  No Pain killers  Not affecting sleep, affects quality of life  Rx  Physio in past made no better

5. .  Treatment  Physiotherapy - ? had some  Education  Not 5 or 10 minutes  Injection???  Surgery  Open  Arthroscopic

6. . GT-S Cambridge Shoulder  Rotator Cuff Disease – subacromail decompression

7. .  Pain in shoulder  2 yrs intermittent  Limiting sleep  Cant sleep on that side  Works in warehouse struggling above shoulder height, no days off  Played rugby in past  Rx  Physiotherapy  Elastic bands – no better  GP cortisone injection  Side – sore no better

8. .  Treatment  Physiotherapy ?????  Education (Normal)  NSAID  Injection  Surgery  Open  Arthroscopic

9. .  6 month hx  Pain and stiffness  Pain slightly better following injection  Swat fly grab cup severe stabbing pain  Struggling above shoulder height  Rx  Injection (temporary)  Physio – made it worse

10. .  Treatment  Phase  Inflammatory  Physiotherapy - relative rest, maintain ROM  Injection  Hydrodilatation  Surgery – No  Frozen  Physiotherapy  Injection ?  Hydrodilatation  Surgery  Thawing phase  Physiotherapy  Injection ????  Hydrodilatation  Surgery ?

11. .  Stiffness and pain 2 yrs  DIY enthusiast  Occ affects sleep  Rx  Uses paracetamol  Had injection  Physio no difference  Therabands – made it worse

12. .  Dx  Beware Dx frozen shoulder without XR  Treatment  Physiotherapy  Maintain state of cuff  Injection ???  Education  Surgery  Arthroscopic  Open

13. .  Manager, desk top work  No sport / hobbies  Pain upper arm  Increasing 6 weeks  Sleep – severe (9/10)  Sudden movement 12/10  Physio  Made worse

14. .  Ix  X ray  MRI  U/S  Treatment  Physiotherapy  Analgesia  Injection  Needle barbotage  Surgery  Arthroscopic barbotage and washout

15. .  Painter decorator  Pain  Arm, limiting activity above shoulder height  Rest 4/10, Night 6/10  Sleep  Weak above shoulder height  Rx  Physio no better  Injection temporary 2 weeks  Ultrasound tear in tendon

16. .  Treatment  Physiotherapy  Education  Injection??  Surgery  Open  Arthroscopic

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18. .  Pain arm 8 weeks  Rest 4/10  Stresses it 8/10  Worse at Gym, Personal trainer  Rx  Deep massage  Rest

19. .  Ix  X ray Os acromiale  MRI  Treatment  Physiotherapy  Balance cuff  Injection ??  Surgery  Open  Arthroscopic

20. .  Fall from tractor grabbed hand rail 2 weeks ago  Sudden severe pain, could not move arm  Rx  Physio  Pain better but still weak

21. .  Ix ?  X ray  MRI/ U/S ??  Treatment  Physiotherapy  Maintain ROM  Rehab remainder of cuff  Injection ??????  Surgery  Open  Arthroscopic

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