1. Trauma
2. Ineffective repair
3. Pain amplification: fibromyalgia
4. Neoplasm
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, Noninflammatory causes of pain
1. Monoarticular: 1 structure
2. Periarticular: 2-3 structures
4. Polyarticular: 4 or more
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Number of joints
1. AP & axillary x-rays of the shoulder: smooth, concentric joint surfaces with intact
cartilage space and rule out other pathology (osteophytes, calcification, tumors)
2. If xray normal: CT, MRI, and arthrography rarely indicated (done by orthopedics)
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Adhesive Capsulitis diagnosis
I. fracture travels through the physis
II. fracture travels through the metaphysis and physis
III. fracture travels through the epiphysis and physis
IV. fracture travels through the metaphysis, epiphysis, and physis
V. fracture involves a compression injury of the physis.
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, Salter-Harris Classification
1. Pathological changes from subacromial bursa and/or rotator cuff
2. Inflamed due to compression under the roof of the shoulder joint.
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Impingement syndrome definition
1. Flexion: 140-150 degrees.
2. Extension: 0-5 degrees.
3. Pronation: 90 degrees.
4. Supination:90 degrees.
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Elbow ROM
1. Painful Active ROM (not passive)
2. Demonstrated point or focal tenderness
3. Findings far from joint capsule
4. Unlikely to see crepitus, instability, or deformity
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Non-articular Pain
, 1. Based on location of pain
2. Testing and treatment are the same.
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Epicondylitis Diagnosis
1. Conservative with relative rest
2. NSAIDS
3. Stretching program with emphasis on posterior capsule stretching
4. No improvement in 6 wks: ultra-sound guided peritendinous steroid injection then
stretching
5. Refer/Surgical eval: Significant weakness or failure to improve after 6 weeks of
rehab (with or without steroid injection)
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Impingement Syndrome Treatment
1. Midlevel back pain, can point to location
2. Worse: Mvmt
3. aching, stabbing, or so severe interferes w/ ADLS
4. Ecchymosis/swelling if trauma
5. Unstable flexion distraction or burst fracture: Hematoma and forward shift
6. Usually between T8 and L4
7. Maybe kyphosis and midline spine tenderness to palpation
8. Neurological changes
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2. Ineffective repair
3. Pain amplification: fibromyalgia
4. Neoplasm
Give this one a try later!
, Noninflammatory causes of pain
1. Monoarticular: 1 structure
2. Periarticular: 2-3 structures
4. Polyarticular: 4 or more
Give this one a try later!
Number of joints
1. AP & axillary x-rays of the shoulder: smooth, concentric joint surfaces with intact
cartilage space and rule out other pathology (osteophytes, calcification, tumors)
2. If xray normal: CT, MRI, and arthrography rarely indicated (done by orthopedics)
Give this one a try later!
Adhesive Capsulitis diagnosis
I. fracture travels through the physis
II. fracture travels through the metaphysis and physis
III. fracture travels through the epiphysis and physis
IV. fracture travels through the metaphysis, epiphysis, and physis
V. fracture involves a compression injury of the physis.
Give this one a try later!
, Salter-Harris Classification
1. Pathological changes from subacromial bursa and/or rotator cuff
2. Inflamed due to compression under the roof of the shoulder joint.
Give this one a try later!
Impingement syndrome definition
1. Flexion: 140-150 degrees.
2. Extension: 0-5 degrees.
3. Pronation: 90 degrees.
4. Supination:90 degrees.
Give this one a try later!
Elbow ROM
1. Painful Active ROM (not passive)
2. Demonstrated point or focal tenderness
3. Findings far from joint capsule
4. Unlikely to see crepitus, instability, or deformity
Give this one a try later!
Non-articular Pain
, 1. Based on location of pain
2. Testing and treatment are the same.
Give this one a try later!
Epicondylitis Diagnosis
1. Conservative with relative rest
2. NSAIDS
3. Stretching program with emphasis on posterior capsule stretching
4. No improvement in 6 wks: ultra-sound guided peritendinous steroid injection then
stretching
5. Refer/Surgical eval: Significant weakness or failure to improve after 6 weeks of
rehab (with or without steroid injection)
Give this one a try later!
Impingement Syndrome Treatment
1. Midlevel back pain, can point to location
2. Worse: Mvmt
3. aching, stabbing, or so severe interferes w/ ADLS
4. Ecchymosis/swelling if trauma
5. Unstable flexion distraction or burst fracture: Hematoma and forward shift
6. Usually between T8 and L4
7. Maybe kyphosis and midline spine tenderness to palpation
8. Neurological changes
Give this one a try later!
