Shoulder Pain DDx - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 05-03-2013
juggernaut97's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 48
Threads: 3
Thanked 49 Times in 19 Posts
Reputation: 59
Rheumatology/Orthopedics Shoulder Pain DDx

How to Differentiate between :

Subacromial Bursitis~
Rotator Cuff Tendinitis~
Rotator Cuff Tear~
Adhesive Capsulitis~



Please Someone Clarify ?
Reply With Quote Quick reply to this message



  #2  
Old 05-03-2013
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 145
Threads: 4
Thanked 120 Times in 75 Posts
Reputation: 130
Default

Rotator Cuff Impingement/Tendonitis: Patient complains of shoulder pain aggrevated by activities like reaching or lifting arm over head. Common in middle aged; repeated activities overhead are the cause. Confirmed by "Neer Test" (passive motion of arm above head). Pain or guarding during the test confirms impingement. To distinguish from other, inject lidocaine; if improvement of range of motion and pain relief acheived, diagnosis confirmed. MRI is definitive test for dx.

Rotator Cuff Tear: chronic impingement and tendonitis or trauma. Symptoms same as above but no improvement seen with lidocaine injection. Weakness of the shoulder also seen. Look for a history of falling on outstretched hands. On Physical Exam: when patient told to abduct arms over head and told to bring down slowly; the affected arm drops rapidly at midpoint of its descent. Drop arm test is diagnostic.
Adhesive Capsulitis: cant lift arm overhead even after lidocaine injection.

Subacromial Bursitis: lies between acromion and tendon of supraspinatus muscle. Inflammation of subacromion bursitis occurs w chronic microtrauma to supraspinatus muscle tendon. This is also caused by overhead work and repeated overhead movements of arm during work or sporting activities (tennis serve). Tendon is compressed between acromion and the humeral head with its vascular supply temporarily compromised.
on P/E: there is pain with active ROM of the shoulder, tenderness in the shoulder with active range of motion of the shoulder, tenderness in the shoulder with arm internally rotated.

Dislocated Shoulder: head of humerus rotates out of the glenoid cavity
Separated Shoulder: clavicle separates from acromion and coracoid process

Hope this helps somewhat. My notes from UW, Kaplan and a bit of First Aid I guess.
Reply With Quote Quick reply to this message
The above post was thanked by:
aaru20 (05-03-2013), dr.Zh (05-03-2013), erickven (01-21-2017), radkur (05-04-2013), spacecadet (05-03-2013), StepIn (05-04-2013), venky2600 (05-03-2013), vnagubandi (05-03-2013)
  #3  
Old 05-03-2013
venky2600's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,186
Threads: 119
Thanked 821 Times in 434 Posts
Reputation: 831
Send a message via Yahoo to venky2600
Post

dude..i think MRI is definitive Dx for rotator cuff tear....

the reason it's used for rotator cuff tendinitis is to differentiate from rotator cuff tear prior to arthroscopic surgery..

please,clarify me if you have any other explanation too...thanks
Reply With Quote Quick reply to this message
 
  #4  
Old 05-04-2013
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 145
Threads: 4
Thanked 120 Times in 75 Posts
Reputation: 130
Default

Quote:
Originally Posted by venky2600 View Post
dude..i think MRI is definitive Dx for rotator cuff tear....

the reason it's used for rotator cuff tendinitis is to differentiate from rotator cuff tear prior to arthroscopic surgery..

please,clarify me if you have any other explanation too...thanks
Yes, the MRI would show the tear and be the best diagnostic test, that been said there is no real need for an expensive test as the drop-arm test is highly sensitive.
Reply With Quote Quick reply to this message
The above post was thanked by:
venky2600 (05-04-2013)



Reply

Tags
Orthopedics-, Rheumatology-

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
My shoulder hurts !!!! next step... tyagee USMLE Step 2 CK Forum 18 05-27-2012 05:37 PM
Severe shoulder and arm pain step1an USMLE Step 2 CK Forum 4 08-20-2011 04:50 PM
Alcoholic with shoulder wound Hope2Pass USMLE Step 1 Forum 9 08-13-2011 08:39 AM
Question: shoulder problem fin-84 USMLE Step 1 Forum 6 11-03-2010 10:48 AM
Shoulder Abductors Sabio USMLE Step 1 Mnemonics 0 09-10-2009 07:02 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)