shoulder – Joint Clinic Paarl

Rotator Cuff Tear

Daan Botes — Wed, 28 Oct 2020 14:44:42 +0000

A rotator cuff tear is an injury where one or more of the tendons or muscles of the rotator cuff of the shoulder get torn. Symptoms may include shoulder pain, which is often worse with movement, or weakness. This may limit people’s ability to brush their hair or put on clothing. Clicking may also occur with movement of the arm.

Tears may occur as the result of a sudden force or gradually over time. Risk factors include certain repetitive activities, smoking, old age and a family history of the condition. Diagnosis is based on symptoms, examination, and medical imaging. The rotator cuff is made up of the supraspinatus, infraspinatus, teres minor, and subscapularis. The supraspinatus is the most commonly affected.

Shoulder Arthritis

Daan Botes — Thu, 30 Apr 2020 13:13:38 +0000

Shoulder arthritis generally causes symptoms such as joint pain and limited range of motion. There are 5 kinds of arthritis of the shoulders:

Rheumatoid Arthritis
Osteoarthritis
Posttraumatic Arthritis
Avacular Necrosis
Cuff Tear Arthropath

Avascular Necrosis Of The Shoulder

Daan Botes — Tue, 28 Apr 2020 13:15:52 +0000

Avascular necrosis of the shoulder (AVN), also called osteonecrosis or bone infarction, is death of bone tissue due to interruption of the blood supply. Early on, there may be no symptoms. Gradually joint pain may develop which may limit the ability to move. Complications may include collapse of the bone or nearby joint surface.

Risk factors include bone fractures, joint dislocations, alcoholism, and the use of high-dose steroids. The condition may also occur without any clear reason. The most commonly affected bone is the femur. Other relatively common sites include the upper arm bone, knee, shoulder, and ankle. Diagnosis is typically by medical imaging such as X-ray, CT scan, or MRI. Rarely biopsy may be used.

Treatments may include medication, not walking on the affected leg, stretching, and surgery. Most of the time surgery is eventually required and may include core decompression, osteotomy, bone grafts, or joint replacement

Shoulder Impingement Syndrome

Saltlicker — Sun, 26 Apr 2020 13:07:56 +0000

Shoulder impingement syndrome is a syndrome involving tendonitis (inflammation of tendons) of the rotator cuff muscles as they pass through the subacromial space, the passage beneath the acromion. It is particularly associated with tendonitis of the supraspinatus muscle. This can result in pain, weakness, and loss of movement at the shoulder.

Frozen Shoulder (Adhesive Capsulitis)

Saltlicker — Thu, 23 Apr 2020 12:55:23 +0000

Adhesive capsulitis, also known as frozen shoulder, is a condition associated with shoulder pain and stiffness. There is a loss of the ability to move the shoulder, both voluntarily and by others, in multiple directions. The shoulder itself; however, does not generally hurt significantly when touched. Muscle loss around the shoulder may also occur. Onset is gradual over weeks to months. Complications can include fracture of the humerus or biceps tendon rupture.

The cause in most cases is unknown. The condition can also occur after injury or surgery to the shoulder. Risk factors include diabetes and thyroid disease. The underlying mechanism involves Inflammation and scarring. The diagnosis is generally based on a person’s symptoms and a physical exam. The diagnosis may be supported by an MRI.

Shoulder Dislocation

Saltlicker — Wed, 22 Apr 2020 13:07:39 +0000

Shoulder Dislocation occurs when the head of the humerus is out of the shoulder joint. Symptoms include shoulder pain and instability. Complications may include a Bankart lesion, Hill-Sachs lesion, rotator cuff tear, or injury to the axillary nerve.

A shoulder dislocation often occurs as a result of a fall onto an outstretched arm or onto the shoulder. Diagnosis is typically based on symptoms and confirmed by X-rays. They are classified as anterior, posterior, inferior, and superior with most being anterior.

Bankart Lesion (Labral Tear)

Saltlicker — Tue, 21 Apr 2020 13:06:09 +0000

A Bankart lesion is an injury of the anterior (inferior) glenoid labrum of the shoulder due to anterior shoulder dislocation. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it. It is an indication for surgery and often accompanied by a Hill-Sachs lesion, damage to the posterior humeral head.

A bony Bankart is a Bankart lesion that includes a fracture of the anterior-inferior glenoid cavity of the scapula bone.

SLAP Lesion Tear

Saltlicker — Mon, 20 Apr 2020 13:09:17 +0000

A SLAP Lesion tear is an injury to the glenoid labrum. Tearing of the labrum can occur from either acute trauma or repetitive shoulder motion such as in the sports of swimming, baseball and football. Acute trauma may be from dislocation of the shoulder, direct blows to the shoulder, and other accidents of the sort. Tears are classified as either superior or inferior in regards to where the tear is in the glenoid cavity.

A SLAP lesion (superior labrum, anterior to posterior) is a tear where the glenoid labrum meets the tendon of the long head of the biceps muscle. Symptoms include increased pain with overhead activity, popping or grinding, loss of strength, and trouble localizing a specific point of pain. Because a SLAP lesion involves the biceps, pain and weakness may also be felt when performing elbow flexion with resistance.

The glenoid labrum (glenoid ligament) is a fibrocartilaginous structure (not a fibrocartilage as previously thought) rim attached around the margin of the glenoid cavity in the shoulder blade. The shoulder joint is considered a ball and socket joint. However, in bony terms the ‘socket’ (the glenoid fossa of the scapula) is quite shallow and small, covering at most only a third of the ‘ball’ (the head of the humerus). The socket is deepened by the glenoid labrum.

Shoulder Bursitis

Saltlicker — Sat, 18 Apr 2020 13:07:10 +0000

Subacromial shoulder bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the overlying coraco-acromial ligament, acromion, and coracoid (the acromial arch) and from the deep surface of the deltoid muscle.

The subacromial bursa helps the motion of the supraspinatus tendon of the rotator cuff in activities such as overhead work.

Sternoclavicular Joint Dislocation

Saltlicker — Fri, 17 Apr 2020 13:08:48 +0000

While not directly a shoulder problem, Sternoclavicular Joint Dislocation may affect shoulder functionality due to problems with sternoclavicular rotation. A sternoclavicular separation occurs when the sternum separates from the clavicle at the sternoclavicular joint.

Sternoclavicular separations (dislocation and subluxation) are rare and generally caused by accident. If the clavicle is separated posteriorly (i.e. the clavicle separates and goes behind the sternum) the situation can be dangerous and the clavicle can cause damage to interior arteries, veins or organs.

An X-ray or CT Scan may be necessary to accurately diagnose a sternoclavicular separation.