Pathogenesis (development of disease) Adhesive inflammation of the shoulder joint capsule results from degenerative changes with calcification, swelling, etc. of the shoulder. Lesions of the rotator cuff (group of four muscles and their tendons that form the roof of the shoulder joint and extend from the scapula to the greater or lesser tuberosity of the … Shoulder Lesions: Causes
Therapy for a shoulder lesion must be strictly cause-related and appropriate to the stage (see the relevant disease for details). General measures Depending on the disease and stage of disease: Relief and immobilization Sports leave In case of osteoarthritis or joint degeneration – see under osteoarthritis. In case of trauma – care depending on the … Shoulder Lesions: Therapy
The medical history (history of the patient) represents an important component in the diagnosis of shoulder lesions. Family history Is there a history of frequent bone/joint disease in your family? Social history What is your profession? Current medical history/systemic history (somatic and psychological complaints). Where exactly is the pain localized? What is the character of … Shoulder Lesions: Medical History
Musculoskeletal system and connective tissue (M00-M99). Biceps tendon rupture – Generic term for rupture of at least one tendon of the biceps brachii muscle (two-headed arm flexor muscle). A distinction is made between proximal biceps tendon rupture (in the shoulder area) and the distal rupture (in the elbow area). Bursitis (bursitis) in rheumatoid arthritis (pcp). … Shoulder Lesions: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by shoulder lesions: Musculoskeletal system and connective tissue (M00-M99). Chronic limitation of movement Chronic shoulder pain Cervicobrachial syndrome (synonym: shoulder-arm syndrome) – pain in the neck, shoulder girdle, and upper extremities. The cause is often the compression or irritation of spinal … Shoulder Lesions: Consequential Diseases
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait (fluid, limping). Body or joint posture (upright, bent, gentle posture). Malpositions (deformities, contractures, shortenings). Muscle atrophies (side … Shoulder Lesions: Examination
2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Rheumatological diagnostics: RF (rheumatoid factor), ANA (antinuclear antibodies), anti-citrulline antibodies – if rheumatoid arthritis is suspected (pcP).
Therapeutic target Reduction of pain and thus increase of the ability to move. Therapy recommendations Analgesia (pain relief) during diagnosis until definitive therapy according to WHO staging scheme: Non-opioid analgesic (paracetamol, first-line agent). Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. If necessary, anti-inflammatory drugs / drugs … Shoulder Lesions: Drug Therapy
Obligatory medical device diagnostics. X-ray of the shoulder, in two planes Optional medical device diagnostics – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Sonography (ultrasound examination) of the shoulder (shoulder sono). Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging method (using magnetic fields, i.e., without … Shoulder Lesions: Diagnostic Tests
To prevent shoulder lesions, attention must be paid to reducing individual risk factors. Behavioral risk factors High-risk sports such as throwing sports Medication Steroids are suspected (studies show low evidence for this).
The following symptoms and complaints may indicate shoulder lesions: Painful restriction of movement Pain especially when lying down Muscular weakness (muscle atrophy/muscle weakness). Shoulder stiffness (“Frozen Shoulder”) Symptoms of rotator cuff rupture: Abduction (lateral guidance of the arm) – is not possible/only possible to a limited extent; if possible, then abduction pain. Feeling of instability … Shoulder Lesions: Symptoms, Complaints, Signs
