Posts Tagged ‘shoulder’

Take a break!

Well done on making it to the end of week 2 of  the MSS!

This is the time to re-cap on your learning so far in relation to the shoulder and hand.  Take a look again at the bone of the week and  case of the  week especially for shoulder and hand stuff.

Week 3 will be focusing on back and neck pain, especially nerve root compression and mechanical   back pain but with something about  other back problems as well – enjoy!



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Shoulder Doc

This website is a really good shoulder resource, containing copies of shoulder texts, anatomy material as well as arthroscopic footage of shoulder procedures and pathology.  Go to the educational menu for the most useful material.  Why not have a look at this before you come to theatre to see shoulder surgery!

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Left Shoulder Xray

This is the Xray of the left shoulder of a 42 year man following a fall  from a height onto his outstretched hand.

He has  a painful, immobile shoulder with  loss of the normal contour of deltoid.

What do you think the Xray shows? (there are two abnormalities to  notice here).

Remembering Prof Parkin’s lecture today it would be important to test his sensation somewhere.

After emergency management his shoulder now looks like this.

Can you say how he as been treated and what might go wrong with his shoulder during the next few days or weeks?

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Recommended reading

Section 8.10 Shoulder Disorders

Short paragraphs on all the shoulder porblems we looked  today with a good photo of a subacromial injection and a dislocated shoulder.

There are self-assessment questions at the end of the chapter.

More recommended reading

Don’t forget to check out Joints p75 and Muscles p77

(not complusory or examinable!Ed)

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Case of the Week – extras

Blackboard has three additional resouces to  look at illustrating the case of the week.  These folders may be slow to open and will need you to click off the pop-up blocker from time to  time.

In the “Case of the Week: shoulder Pain”,  folder in the resouces menu there’s:

  1. Shoulder examination video from Swansea med school with a detailed examination done by a physiotherapist.
  2. “Mr Murray, patient with shoulder pain”, is an interacitve virtual patient diagnosis and management problem.  This unfortunate patient, now aged 75y, has been dogged by shoulder problems since he was 35y.  Only you can ultimately save him from further pain!
  3. Patient with shoulder pain.  Another presentation along the same lines which I made recently with  colleagues in  medical education for an interactive, synchronous broadcast to Indonesia, Malaysia and Rumania put on  by MedEd World.  This time it’s about Stephan! Sorry it’s not interactive any more – – I only got the ppt version to keep.  Enjoy!

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Useful links

Thanks for these two useful links people have given me today.

www.handuniversity .com has good sections on trigger finger, carpal   tunnnel syndrome and Dupuytrens’ contracture.  All good reading prior to upcoming lectures.

www.swarminteractive.com has good stuff on shoulder procedures discussed in our patient presentation  today.  Follow the path to –  patient education – to – view animations – to – orthopaedics – to – shoulder  and BINGO!    (Don’t click the, “Subscribe now”  button!, ed)

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OA of acromioclavicular joint

This 70 year old man is complaining  of shoulder pain when he moves his arm.

There is no  history of trauma and no limitation of shoulder movement.  It’s just painful to do!

Significantly on examination there is no  weakness of rotator cuff function and no painful arc on abduction.

This pain Xray shows a normal gleno-humeral  joint.  There is some superior migration of the humerus suggesting rotator cuff thinning.

The AC  joint shows some features of osteoarthritis.  Can you say which of these features you can identify on the X-ray?

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