OrthoNet

MCQs-shoulder 2
If they are not having much PAIN and are just limited by weakness - not sure exactly how this changes things. Typically, in older patients we operate to help the pain. If a young patient were to sustain a sudden injury and have rotator cuff symptoms, that patient I’d fix right away.

- the best test for rotator cuff after MRI is arthrography.

- acromial morphology is best associated with incidence of full thickness rotator cuff tearing. (Type III)

- adhesive capsulitis is seen with diabetics in particular. Also with other “fibromatosis” - peyronies, dupuytrens, plantar fibromatosis, Garrods nodes, hypothyroidism, phenobarbitol use.

- for the acute proximal biceps tendon rupture - do nothing; physio to get them moving. No reason to go in and fix.

- Charcot arthropathy secondary to syrinx - NONoperative Rx only.

- onset of shoulder pain with deltoid atrophy and triceps atrophy - C5 and C7 - weird. Probably a plexus neuritis to affect them both.

- the most important risk factor for clavicular nonunion is displacement of fracture

- staple capsuloraphy has a high rate of complication when used in the shoulder; all arthroscopic stapling procedures are frought with complications.

- the pitcher subluxes his shoulder during late cocking (begins with the pitcher putting his foot down); The severe abduction and external rotation in late cocking causes posterosuperior impingement and levers the anterior head out the front - thus stretching out the anterior capsule. The rotator cuff hast to work harder to keep the shoulder in. When the cuff fatigues - more instability. Note: if this pt comes in with labral pathology, you need to address the instability primarily, not just the labral pathology.