shoulder joint dd

8/14/2019 Shoulder Joint DD

1/14

Shoulder Joint

Acromioclavicular sprain: Pain and crepitis on

palpation.

+ Ve test: Cross body adduction, OBriens test (seatedwith UE in 90 of elevation, 10 of horizontal add and

maximal IR (pronation). Resist elevation in IR and ER

Muhammed Al-Jarrah PhD, PT


2/14

Labor Tear Pain with IR and adduction

Weakness with abduction and flexion

Sense of instability

+ve Test: Biceps load, Speeds and OBriens

Confirmed with CT and MRI


3/14

Subacromial bursitis Onset of severe pain, localized in deltoid

insertion. Passive shoulder ext to palpate the

bursa PROM is painful and resisted motions are not

painful except through the painful arch.

+Ve tests: Hawkins Kennedys, Neers test Imaging is of little value


4/14

Bicipital tendinitis Pain @ night

10 of IR (places the tendon directly anterior

and 6 cm below acromion) Active elevation results in painful arch

+Ve speed test, -Ve Yergasons for click but

painful Often associated with RC impingement


5/14

Calcific Tendinitis ROM with painful arch 70-110 and

sensation of catching when going through

ROM Need to rule our adhesive capsulitis

+Ve speed test


6/14


7/14

Rotator cuff strain Night pain, deep ache

Weakness: Abduction and/or ER

+Ve special tests: Depends on muscleinvolved.


8/14

Supraspinatus Impingement Pain specially when sleeping on affected side

Painful arch (60-120)

Catching with flexion and IR Little to no TTP

ROM with IR and horizontal adduction

Posterior capsule tightness Rule out other shoulder disorders


9/14


10/14

Adhesive Capsulitis Pain radiating to elbow, night pain

Kyphotic posture, shoulder hiking

Low grade inflammatory respond

Empty end feel

Stages of Adhesive Capsulitis

- Freezing

- Frozen- Thawing


11/14

Shoulder BP: Muscles and function

Median nerve: C6-8, T1

Muscles: Pronator teres, FCR, Palmaris longus,

thenar eminence, lateral 2 lumbriclesFunctional deficits: Weak pronation, wrist

flexion & RD

Weak thumb flexion & abduction

Weak grip and pinch


12/14


Ulnar Nerve: C7-8, T1

Muscles: FCR, Palmaris brevis, edductor

pollicic, medial 2 lumbricales, interossei, andhypothenar eminence

Functional deficits: Weak wrist flexion and UD

Weak fifth finger flexion, weak fingerabduction/adductor

Benediction sign.


13/14


Radial Nerve: C5-8, T1

Muscles: Anconeus, brachioradialis, ECRL,

ECRB, extensor digitorum, extensor indicic,extensor digiti minimi

Functional deficits: Weak supination, wrist

extension, fingure flexion, thumb abduction,weak grip due to loss of wrist stabilization.


14/14

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shoulder joint dd

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