Ortho Exam 2 (Frozen Shoulder, rTSA, mallet finger, Hill-Sachs/reverse Hill-Sachs, Median n entrapment, absent reflexes)

I/II
In regards to AC joint injury, these Grades: Non operative, use Sling, Ice, NSAIDS, 1-2 wks start ROM, progressive strengthening when pain free

Sling/ice/NSAIDS
In regards to AC joint injury, Grade I/II: Non operative, use these, 1-2 wks start ROM, progressive strengthening when pain free

1-2 weeks
In regards to AC joint injury, Grade I/II: Non operative, use Sling, Ice, NSAIDS, in this time start ROM, progressive strengthening when pain free

ROM
In regards to AC joint injury, Grade I/II: Non operative, use Sling, Ice, NSAIDS, 1-2 wks start this, progressive strengthening when pain free

Strengthening
In regards to AC joint injury, Grade I/II: Non operative, use Sling, Ice, NSAIDS, 1-2 wks start ROM, progressive this when pain free

3-6 weeks
In regards to AC joint injury, Grade III: Controversial on Tx, use Sling this long, possible Surgery, Screws, Tape, Suture, Allograft reinforcement

Sling
In regards to AC joint injury, Grade III: Controversial on Tx, use this 3-6 wks, possible Surgery, Screws, Tape, Suture, Allograft reinforcement

Screws/tape/suture/allograft reinforcement
In regards to AC joint injury, Grade III: Controversial on Tx, use Sling 3-6 wks, possible Surgery (these in particular)

IV/V/VI
In regards to AC joint injury, these Grades: surgical intervention (complications)

Depends
In regards to impingements & rotator cuff lesions, which occurs first?

Coracoacromial arch
This consists of: Anterior Acromion, Coracoacromial Lig, Distal Clavicle, Subacromial Bursa

Ant acromion/coracoacromial lig/clavicle/subacromial bursa
Coracoacromial Arch consists of these

Anatomic/mechanical
These type causes of impingement/RCT’s: Anterior Acromial Spur, Shape/Slope of Acromion, Prominent AC joint, Os Acromiale

Impingement/RCT
Anatomic/Mechanical causes of these: Anterior Acromial Spur, Shape/Slope of Acromion, Prominent AC joint, Os Acromiale

Ant acromial spur/acromion shape/slope/prominent AC joint/os acromiale
Anatomic/Mechanical causes of impingement/RCT’s: these

Rotator cuff tear
RCT

Outlet impingement
“This” is the primary cause of most RCT’s/biceps lesions

RCT/biceps lesions
“Outlet impingement” is the primary cause of most these

Primary
In regards to overuse etiology: this type Impingement: Repetitious microtrauma –> Cuff Tendonitis & Bursitis –> Impingement

Cuff tendonitis/bursitis
In regards to overuse etiology: Primary Impingement: Repetitious microtrauma –> these –> Impingement

Secondary
In regards to overuse etiology: this type Impingement: RC weakness/Scapular Stabilizer Weakness/RC Fatigue leads to increased GH superior head migration which leads to Impingement

RC/scap stabilizer weakness/fatigue
In regards to overuse etiology: Secondary Impingement (Theory 1): these lead to increased GH superior head migration which leads to Impingement

GH sup head migration
In regards to overuse etiology: Secondary Impingement (Theory 1): RC weakness/Scapular Stabilizer Weakness/RC Fatigue leads to increased this which leads to Impingement

Secondary
In regards to overuse etiology: this type Impingement: Clinical or Subclinical Instability -> Intrinsic tension overload &/or sup HH migration -> impingement

Clinical/subclinical instability
In regards to overuse etiology: Secondary Impingement (Theory 2): this -> Intrinsic tension overload &/or sup HH migration -> impingement

Intrinsic tension overload &/or sup HH migration
In regards to overuse etiology: Secondary Impingement (Theory 2): Clinical or Subclinical Instability -> this -> impingement

Posterior Impingement Syndrome
This is seen in overhead athletes (swimmers/throwers/racquet sports) w/arm position “cocking phase”; Infra/Supraspinatus are pinched btwn post/sup aspect of glenoid; lesion is on undersurface of rotator cuff; often associated w/anterior instability

Overhead athletes
Posterior Impingement Syndrome is seen in this population; Infra/Supraspinatus are pinched btwn post/sup aspect of glenoid; lesion is on undersurface of rotator cuff; often associated w/anterior instability

Cocking
Posterior Impingement Syndrome is seen in overhead athletes (swimmers/throwers/racquet sports) w/arm position “this phase”; Infra/Supraspinatus are pinched btwn post/sup aspect of glenoid; lesion is on undersurface of rotator cuff; often associated w/anterior instability

Infra/Supraspinatus
Posterior Impingement Syndrome is seen in overhead athletes (swimmers/throwers/racquet sports) w/arm position “cocking phase”; these are pinched btwn post/sup aspect of glenoid; lesion is on undersurface of rotator cuff; often associated w/anterior instability

Post/sup aspect of glenoid
Posterior Impingement Syndrome is seen in overhead athletes (swimmers/throwers/racquet sports) w/arm position “cocking phase”; Infra/Supraspinatus are pinched btwn these; lesion is on undersurface of rotator cuff; often associated w/anterior instability

Undersurface of RC
Posterior Impingement Syndrome is seen in overhead athletes (swimmers/throwers/racquet sports) w/arm position “cocking phase”; Infra/Supraspinatus are pinched btwn post/sup aspect of glenoid; lesion is this; often associated w/anterior instability

Anterior instability
Posterior Impingement Syndrome is seen in overhead athletes (swimmers/throwers/racquet sports) w/arm position “cocking phase”; Infra/Supraspinatus are pinched btwn post/sup aspect of glenoid; lesion is on undersurface of rotator cuff; often associated w/this

Ant dislocation
Traumatic etiology for RCT: Single Violent Event, this >40 years, Extend a Pre-existing Tear

40
Traumatic etiology for RCT: Single Violent Event, Anterior Dislocation >this age, Extend a Pre-existing Tear

Extend pre-existing tear
Traumatic etiology for RCT: Single Violent Event, Anterior Dislocation
>40 years, or this

Impingement Syndrome
Stages of this: I (Edema/Hemmorage), II (Fibrosis/Tendonitis), III (Bone Spurs/Tendon Rupture)

Edema/hemmorage
Stages of Impingement Syndrome: I (these), II (Fibrosis/Tendonitis), III (Bone Spurs/Tendon Rupture)

Fibrosis/tendonitis
Stages of Impingement Syndrome: I (Edema/Hemmorage), II (these), III (Bone Spurs/Tendon Rupture)

Bone spurs/tendon rupture
Stages of Impingement Syndrome: I (Edema/Hemmorage), II (Fibrosis/Tendonitis), III (these)

25-40/recurrent pain
Impingement Syndrome Stage II
(Fibrosis/Tendonitis): this age range; this w/activity; bursectomy or CA lig resection; Subacromial Decompression

Bursectomy/CA lig resection
Impingement Syndrome Stage II
(Fibrosis/Tendonitis): 25-40 yo; recurrent pain w/activity; possibly one of these interventions; Subacromial Decompression

Subacromial decompression
Impingement Syndrome Stage II
(Fibrosis/Tendonitis): 25-40 yo; recurrent pain w/activity; bursectomy or CA lig resection; possibly this intervention

>40
Impingement Syndrome Stage III
(Bone Spurs/Tendon Ruptures): this age range; Progressive Disability; Partial or Complete Tears; Subacromial Decompression & Rotator Cuff Repair

Progressive
Impingement Syndrome Stage III
(Bone Spurs/Tendon Ruptures): >40 yo; this type Disability; Partial or Complete Tears; Subacromial Decompression & Rotator Cuff Repair

Partial/complete tear
Impingement Syndrome Stage III
(Bone Spurs/Tendon Ruptures): >40 yo; Progressive Disability; one of these; Subacromial Decompression & Rotator Cuff Repair

Subacromial decompression/RC repair
Impingement Syndrome Stage III
(Bone Spurs/Tendon Ruptures): >40 yo; Progressive Disability; Partial or Complete Tears; these interventions

Biceps tendon rupture
This is a cosmetic deformity; Popeye muscle; 20% decrease in flexion strength; can tenodese tendon; may need to debride stump in joint

20/tenodese tendon
Biceps tendon rupture is a cosmetic deformity; Popeye muscle; this% decrease in flexion strength; can do this; may need to debride stump in joint

Debride stump in joint
Biceps tendon rupture is a cosmetic deformity; Popeye muscle; 20% decrease in flexion strength; can tenodese tendon; may need to do this

RCT
Types of these: Bursal surface, Tensile Failure, Undersurface, Full thickness

Bursal surface/tensile failure/undersurface/full thickness
Types of RCT’s: these

<1cm
Classification of Full Thickness tear size, small would be this

1-3cm
Classification of Full Thickness tear size, moderate would be this

3-5cm
Classification of Full Thickness tear size, large would be this

>5cm
Classification of Full Thickness tear size, massive would be this

Moderate
Classification of Full Thickness tear size, this would be 1-3cm

Large
Classification of Full Thickness tear size, this would be 3-5cm

Massive RCT
This pathology: Cuff slips down (subscapularis/infraspinatus remnants) & acts as a HH elevator

Subscap/infraspinatus
Massive RCT: Cuff slips down (these remnants) & acts as a HH elevator

HH elevator
Massive RCT: Cuff slips down (subscapularis/infraspinatus remnants) & acts as this

Enlarge/pain
In regards to RCT: no evidence of healing in full thickness tear; small tears usually will do this w/time; this not related to tear size; may develop arthritis; surgery better early than late

Tear size/arthritis
In regards to RCT: no evidence of healing in full thickness tear; small tears usually will enlarge w/time; pain not related to this; may develop this; surgery better early than late

Strength/fxn
In regards to RCT: these related to tear size; surgery gives predictable pain relief, less predictable for strength; residual overhead fatiquability may limit overhead work post-op

Tear size/surgery
In regards to RCT: strength/fxn related to this; this gives predictable pain relief, less predictable for strength; residual overhead fatiquability may limit overhead work post-op

Pain relief/strength
In regards to RCT: strength/fxn related to tear size; surgery gives predictable this, less predictable for this; residual overhead fatiquability may limit overhead work post-op

Residual overhead fatiquability
In regards to RCT: strength/fxn related to tear size; surgery gives predictable pain relief, less predictable for strength; this may limit overhead work post-op

Overhead post-op work
In regards to RCT: strength/fxn related to tear size; surgery gives predictable pain relief, less predictable for strength; residual overhead fatiquability may limit this

Arthroscopic
In regards to clinical exams in predicting RC pathology: physical & this type exam show 80-85% agreement (PT’s); sensitivity of clinical exam including special tests is 91%, w/specificity of 75%, thus a good clinical exam would be more cost effective than MRI, X-ray, or arthrogram.

80-85
In regards to clinical exams in predicting RC pathology: physical & arthroscopic exam show this% agreement (PT’s); sensitivity of clinical exam including special tests is 91%, w/specificity of 75%, thus a good clinical exam would be more cost effective than MRI, X-ray, or arthrogram.

91/75
In regards to clinical exams in predicting RC pathology: physical & arthroscopic exam show 80-85% agreement (PT’s); sensitivity of clinical exam including special tests is this%, w/specificity of this%, thus a good clinical exam would be more cost effective than MRI, X-ray, or arthrogram.

MRI/x-ray/arthrogram
In regards to clinical exams in predicting RC pathology: physical & arthroscopic exam show 80-85% agreement (PT’s); sensitivity of clinical exam including special tests is 91%, w/specificity of 75%, thus a good clinical exam would be more cost effective than these particular imaging

Open acromioplasty
Advantages to this RCT intervention: More complete sub-acromial decompression, if tear encountered it can be repaired no matter what size.

Sub-acromial decompression
Advantages to Open Acromioplasty: More complete this, if tear encountered it can be repaired no matter what size.

Size
Advantages to Open Acromioplasty: More complete sub-acromial decompression, if tear encountered it can be repaired no matter this

SLAP lesions
These are hard to diagnose, high level of suspicion, from sudden contraction of biceps/repetitive overhead activity, instability often assoc. (determine which came first)

Sudden biceps contraction/repetitive overhead activity
SLAP lesions are hard to diagnose, high level of suspicion, from one of these, instability often assoc. (determine which came first)

Instability
SLAP lesions are hard to diagnose, high level of suspicion, from sudden contraction of biceps/repetitive overhead activity, this is often assoc. (determine which came first)

Sulcus/45
SGHL checks this & @this many deg of elevation it winds around HH w/IR/ER; MGHL is absent in 20% of population, anterior stability btwn 45-90 deg elevation; IGHL is prime stabilizer (ant/post) in abductor shoulder, IR tightens posterior band, ER tightens anterior band.

HH
SGHL checks sulcus & @45 deg of elevation it winds around this w/IR/ER; MGHL is absent in 20% of population, anterior stability btwn 45-90 deg elevation; IGHL is prime stabilizer (ant/post) in abductor shoulder, IR tightens posterior band, ER tightens anterior band.

IR/ER
SGHL checks sulcus & @45 deg of elevation it winds around HH w/these motions; MGHL is absent in 20% of population, anterior stability btwn 45-90 deg elevation; IGHL is prime stabilizer (ant/post) in abductor shoulder, IR tightens posterior band, ER tightens anterior band.

20
SGHL checks sulcus & @45 deg of elevation it winds around HH w/IR/ER; MGHL is absent in this% of population, anterior stability btwn 45-90 deg elevation; IGHL is prime stabilizer (ant/post) in abductor shoulder, IR tightens posterior band, ER tightens anterior band.

Anterior
SGHL checks sulcus & @45 deg of elevation it winds around HH w/IR/ER; MGHL is absent in 20% of population, this stability btwn 45-90 deg elevation; IGHL is prime stabilizer (ant/post) in abductor shoulder, IR tightens posterior band, ER tightens anterior band.

45-90
SGHL checks sulcus & @45 deg of elevation it winds around HH w/IR/ER; MGHL is absent in 20% of population, anterior stability btwn this deg elevation; IGHL is prime stabilizer (ant/post) in abductor shoulder, IR tightens posterior band, ER tightens anterior band.

Ant/post
SGHL checks sulcus & @45 deg of elevation it winds around HH w/IR/ER; MGHL is absent in 20% of population, anterior stability btwn 45-90 deg elevation; IGHL is prime stabilizer (these) in abductor shoulder, IR tightens posterior band, ER tightens anterior band.

Traumatic Unidirectional/Unilateral Bankart Surgery to fix
TUBS classification according to Matsen

Atraumatic/aquired Multidirectional Bilateral Rehab Inferior Cap Shift Interval RC
AMBRII classification according to Matsen

TUBS
“Torn loose” would be under this Matsen classification

AMBRII
“Born loose” would be under this Matsen classification

Normal laxity/instability
Factors to consider when establishing direction of instability: this Vs. this; establishing positions & circumstances in which instability occurs (Football Lineman, Swimmer, UPS worker)

Positions/circumstances in which instability occurs
Factors to consider when establishing direction of instability: Normal Laxity Vs. Instability; establishing these (Football Lineman, Swimmer, UPS worker)

Acute
With shoulder dislocation, if this check neurovascular status, middle aged >40 check RC integrity, assessment of GH joint stability

Neurovascular status
With shoulder dislocation, if acute check this, middle aged >40 check RC integrity, assessment of GH joint stability

40
With shoulder dislocation, if acute check neurovascular status, middle aged >this age check RC integrity, assessment of GH joint stability

RC integrity
With shoulder dilocation, if acute check neurovascular status, middle aged >40 check this, assessment of GH joint stability

GH joint stability
With shoulder dislocation, if acute check neurovascular status, middle aged >40 check RC integrity, assessment of this

Motion/strength
With shoulder dislocation rehab, focus on Immediate these, Prevent RC Shutdown, Reestablish Dynamic Stability, Regain Proprioception; full motion attained within 2 weeks

RC shutdown
With shoulder dislocation rehab, focus on Immediate Motion/Strength, Prevent this, Reestablish Dynamic Stability, Regain Proprioception; full motion attained within 2 weeks

Dynamic stability
With shoulder dislocation rehab, focus on Immediate Motion/Strength, Prevent RC Shutdown, Reestablish this, Regain Proprioception; full motion attained within 2 weeks

Proprioception
With shoulder dislocation rehab, focus on Immediate Motion/Strength, Prevent RC Shutdown, Reestablish Dynamic Stability, Regain this; full motion attained within 2 weeks

2 weeks
With shoulder dislocation rehab, focus on Immediate Motion/Strength, Prevent RC Shutdown, Reestablish Dynamic Stability, Regain Proprioception; full motion attained within this time

Shoulder replacement
This may be indicated w/: OA, RA, AVN, Fracture, Tumor, Rotator Cuff Tear Arthropathy

OA/RA/AVN/Fx/tumor/RCT arthropathy
Shoulder replacement may be indicated w/these

Hemi Arthroplasty
This intervention involves only humeral component; indicated when HH is involved; often seen in proximal HH Fx or AVN; Glenoid intact; heavy demands following surgery due to glenoid loosening

HH
Hemi Arthroplasty involves only this component; indicated when this is involved; often seen in proximal this Fx or AVN; Glenoid intact; heavy demands following surgery due to glenoid loosening

Proximal HH Fx/AVN
Hemi Arthroplasty involves only humeral component; indicated when HH is involved; often seen in one of these pathologies; Glenoid intact; heavy demands following surgery due to glenoid loosening

Intact
Hemi Arthroplasty involves only humeral component; indicated when HH is involved; often seen in proximal HH Fx or AVN; Glenoid is this; heavy demands following surgery due to glenoid loosening

Glenoid loosening
Hemi Arthroplasty involves only humeral component; indicated when HH is involved; often seen in proximal HH Fx or AVN; Glenoid intact; heavy demands following surgery due to this

Reverse Total Shoulder Arthroplasty
rTSA

rTSA
May need this intervention due to RC Arthropathy, complex Fx, based shifting axis of rotation of shoulder, mechanical enhancement of deltoid as prime mover; used in Europe over 20 years

RC arthropathy/complex Fx
May need rTSA due to these, revisions of TSA, based shifting axis of rotation of shoulder, mechanical enhancement of deltoid as prime mover; used in Europe over 20 years; Rehab and Precautions Different from TSA

TSA revisions/based shifting axis of rotation of shoulder
May need rTSA due to RC Arthropathy, complex Fx, these, mechanical enhancement of deltoid as prime mover; used in Europe over 20 years; Rehab and Precautions Different from TSA

Mechanical enhancement of deltoid as prime mover
May need rTSA due to RC Arthropathy, complex Fx, revisions of TSA, based shifting axis of rotation of shoulder; used in Europe over 20 years; Rehab and Precautions Different from TSA

Yes
May need rTSA due to RC Arthropathy, complex Fx, revisions of TSA, based shifting axis of rotation of shoulder, mechanical enhancement of deltoid as prime mover; used in Europe over 20 years; Are Rehab and Precautions Different from TSA?

TSA
Indications for this intervention: Pain Relief (up to 90% have reported pain relief following this in OA; only 60-70% pain relief in Fx/RCTA), Functioning Deltoid, Functional RC if possible (especially posterior cuff), Motivated pt, OA/RA, Fx, Tumor, AVN, RC Arthropathy

90
Indications for TSA: Pain Relief (up to this% have reported pain relief following TSA in OA; only 60-70% pain relief in Fx/RCTA), Functioning Deltoid, Functional RC if possible (especially posterior cuff), Motivated pt, OA/RA, Fx, Tumor, AVN, RC Arthropathy

OA/60-70
Indications for TSA: Pain Relief (up to 90% have reported pain relief following TSA in this condition; only this% pain relief in Fx/RCTA), Functioning Deltoid, Functional RC if possible (especially posterior cuff), Motivated pt, OA/RA, Fx, Tumor, AVN, RC Arthropathy

Fx/RCTA
Indications for TSA: Pain Relief (up to 90% have reported pain relief following TSA in OA; only 60-70% pain relief in these conditions), Functioning Deltoid, Functional RC if possible (especially posterior cuff), Motivated pt, OA/RA, Fx, Tumor, AVN, RC Arthropathy

Deltoid/RC
Indications for TSA: Pain Relief (up to 90% have reported pain relief following TSA in OA; only 60-70% pain relief in Fx/RCTA), Functioning this, Functional this if possible (especially posterior cuff), Motivated pt, OA/RA, Fx, Tumor, AVN, RC Arthropathy

Posterior cuff/motivated
Indications for TSA: Pain Relief (up to 90% have reported pain relief following TSA in OA; only 60-70% pain relief in Fx/RCTA), Functioning Deltoid, Functional RC if possible (especially this), this type pt, OA/RA, Fx, Tumor, AVN, RC Arthropathy

OA/RA/FX/Tumor/AVN/RC arthropathy
Indications for TSA: Pain Relief (up to 90% have reported pain relief following TSA in OA; only 60-70% pain relief in Fx/RCTA), Functioning Deltoid, Functional RC if possible (especially posterior cuff), Motivated pt, these conditions

TSA
Contraindications for this intervention: Neuro compromise of shoulder complex,
significant Deltoid or RC dysfunction, Unrealistic expectations of pt in regards to fxn especially w/deficient RC

Neuro compromise
Contraindications for TSA: this of shoulder complex, significant Deltoid or RC dysfunction, Unrealistic expectations of pt in regards to fxn especially w/deficient RC

Deltoid/RC
Contraindications for TSA: Neuro compromise of shoulder complex, significant dysfunction of one of these, Unrealistic expectations of pt in regards to fxn especially w/deficient RC

Deficient RC
Contraindications for TSA: Neuro compromise of shoulder complex, significant Deltoid or RC dysfunction, Unrealistic expectations of pt in regards to fxn especially w/this

Adhesive capsulitis/scapulohumeral periarthritis/tenobursitis
These are synonymous w/frozen shoulder; Duplay was 1st to describe the condition in 1872; term “frozen shoulder” was actually coined by Codman in 1934, thus Nevasier coined the term “adhesive capsulitis”; Clinical picture: stiff, painful, 40 yo white, female

Frozen shoulder
Adhesive capsulitis, scapulohumeral periarthritis & tenobursitis are synonymous w/this; Duplay was 1st to describe the condition in 1872; term “this” was actually coined by Codman in 1934, thus Nevasier coined the term “adhesive capsulitis”; Clinical picture: stiff, painful, 40 yo white, female

Adhesive capsulitis
Adhesive capsulitis, scapulohumeral periarthritis & tenobursitis are synonymous w/frozen shoulder; Duplay was 1st to describe the condition in 1872; term “frozen shoulder” was actually coined by Codman in 1934, thus Nevasier coined the term “this”; Clinical picture: stiff, painful, 40 yo white, female

Stiff/painful/40 yo white female
Adhesive capsulitis, scapulohumeral periarthritis & tenobursitis are synonymous w/frozen shoulder; Duplay was 1st to describe the condition in 1872; term “frozen shoulder” was actually coined by Codman in 1934, thus Nevasier coined the term “adhesive capsulitis”; Clinical picture: these

Frozen shoulder
Epidemiology of this: F>M, more common in non-dominant arm, approx 12% develop condition bilaterally, most commonly noted in 5th & 6th decade, same shoulder is rarely affected twice, 20-40% of individuals affected have residual stiffness, avg period lasts approx 9-24 months, incidence of this to be approx 3x greater in whites than in blacks

Non-dominant/12
Epidemiology of frozen shoulder: F>M, more common in this arm, approx this% develop condition bilaterally, most commonly noted in 5th & 6th decade, same shoulder is rarely affected twice, 20-40% of individuals affected have residual stiffness, avg lasts approx 9-24 months

Bilaterally
Epidemiology of frozen shoulder: F>M, more common in non-dominant arm, approx 12% develop this, most commonly noted in 5th & 6th decade, same shoulder is rarely affected twice, 20-40% of individuals affected have residual stiffness, avg period lasts approx 9-24 months, incidence of adhesive capsulitis to be approx 3x greater in whites than in blacks

5-6
Epidemiology of frozen shoulder: F>M, more common in non-dominant arm, approx 12% develop condition bilaterally, most commonly noted in these decades, same shoulder is rarely affected twice, avg period lasts approx 9-24 months, incidence of adhesive capsulitis to be approx 3x greater in whites than in blacks

Affected twice/20-40
Epidemiology of frozen shoulder: F>M, more common in non-dominant arm, approx 12% develop condition bilaterally, same shoulder is rarely this, this% of individuals affected have residual stiffness, avg period lasts approx 9-24 months, incidence of adhesive capsulitis to be approx 3x greater in whites than in blacks

Residual stiffness/9-24 months
Epidemiology of frozen shoulder: F>M, more common in non-dominant arm, most commonly noted in 5th & 6th decade, same shoulder is rarely affected twice, 20-40% of individuals affected have this, avg period lasts approx this long, incidence of adhesive capsulitis to be approx 3x greater in whites than in blacks

3x
Epidemiology of frozen shoulder: F>M, more common in non-dominant arm, approx 12% develop condition bilaterally, most commonly noted in 5th & 6th decade, same shoulder is rarely affected twice, 20-40% of individuals affected have residual stiffness, incidence of adhesive capsulitis to be approx this much greater in whites than in blacks

Whites
Epidemiology of frozen shoulder: more common in non-dominant arm, approx 12% develop condition bilaterally, same shoulder is rarely affected twice, 20-40% of individuals affected have residual stiffness, avg period lasts approx 9-24 months, incidence of adhesive capsulitis to be approx 3x greater in whites or blacks?

Frozen shoulder
Traditional mgmt of this: Capsular Stretching, Exercise (use of PNF, isometrics, pendulum/pulley exercises are all of great use), Manipulation, Surgery (MUA – moves shoulder to break capsule lose)

Capsular
Traditional mgmt of frozen shoulder: this Stretching, Exercise (use of PNF, isometrics, pendulum/pulley exercises are all of great use), Manipulation, Surgery (MUA – moves shoulder to break capsule lose)

PNF/isometrics/pendulum/pulley
Traditional mgmt of frozen shoulder: Capsular Stretching, Exercise (use of these exercises are all of great use), Manipulation, Surgery (MUA – moves shoulder to break capsule lose)

Manipulation/MUA
Traditional mgmt of frozen shoulder: Capsular Stretching, Exercise (use of PNF, isometrics, pendulum/pulley exercises are all of great use), this, Surgery (this – moves shoulder to break capsule lose)

Break capsule loose
Traditional mgmt of frozen shoulder: Capsular Stretching, Exercise (use of PNF, isometrics, pendulum/pulley exercises are all of great use), Manipulation, Surgery (MUA – moves shoulder to do this)

Frozen shoulder
For this condition: Hot pack/US/TENS have little effects, Steroid Injections show slight improvement, Ther Ex/Mobilization work better, Manipulation best results

Hot pack/US/TENS
For frozen shoulder: these have little effect, Steroid Injections show slight improvement, Ther Ex/Mobilization work better, Manipulation best results

Steroid injections
For frozen shoulder: Hot pack/US/TENS have little effects, these show slight improvement, Ther Ex/Mobilization work better, Manipulation best results

Ther Ex/mobilization
For frozen shoulder: Hot pack/US/TENS have little effects, Steroid Injections show slight improvement, these work better, Manipulation best results

Manipulation
For frozen shoulder: Hot pack/US/TENS have little effects, Steroid Injections show slight improvement, Ther Ex/Mobilization work better, this has best results

Sidelying ER/Prone ER @90
RC exercises: these for infraspinatus, Prone Ext w/ER (TM), Standing or Sidelying IR (SuS), Scaption in POS (ER—>IR) (SS), Prone Scaption(SS/Lower Trap)

Infraspinatus/prone ext w/ER
RC exercises: Sidelying ER (this muscle), this for teres minor, Standing or Sidelying IR (SuS), Scaption in POS (ER—>IR) (SS), Prone Scaption(SS/Lower Trap), Prone ER @ 90 deg. (this muscle)

Teres minor
RC exercises: Sidelying ER (IS), Prone Ext w/ER (this muscle), Standing or Sidelying IR (SuS), Scaption in POS (ER—>IR) (SS), Prone Scaption(SS/Lower Trap), Prone ER @ 90 deg. (IS)

Standing or sidelying IR
RC exercises: Sidelying ER (IS), Prone Ext w/ER (TMin), this for Subscapularis, Scaption in POS (ER—>IR) (SS), Prone Scaption(SS/Lower Trap), Prone ER @ 90 deg. (IS)

Scaption in POS/ER->IR
RC exercises: Sidelying ER (IS), Prone Ext w/ER (TMin), Standing or Sidelying IR (SuS), this for supraspinatus, Prone Scaption(SS/Lower Trap), Prone ER @ 90 deg. (IS)

Supraspinatus/prone scaption
RC exercises: Sidelying ER (IS), Prone Ext w/ER (TMin), Standing or Sidelying IR (SuS), Scaption in POS (ER—>IR) (for this muscle), this (SS/Lower Trap), Prone ER @ 90 deg. (IS)

Supraspinatus/lower trap
RC exercises: Sidelying ER (IS), Prone Ext w/ER (TMin), Standing or Sidelying IR (SuS), Scaption in POS (ER—>IR) (SS), Prone Scaption (for these muscles), Prone ER @90 (IS)

Frwd head/shoulders
With RC Decompression, important is Education/Modify Activity; Posture – address these; Address Tight Soft Tissues promoting aberrant mechanics; Modalities using palp positions; Mobilize Capsule -Depends?; Core RC Exercises; Scapular Stabilizers; Mvmt Awareness Drills

Tight soft tissues promoting aberrant mechanics
With RC Decompression, important is Education/Modify Activity; Posture – Frwd head, Shoulders; Address these; Modalities using palp positions; Mobilize Capsule -Depends?; Core RC Exercises; Scapular Stabilizers; Mvmt Awareness Drills

Palpation/mobilize capsule
With RC Decompression, important is Education/Modify Activity; Posture – Frwd head, Shoulders; Address Tight Soft Tissues promoting aberrant mechanics; Modalities using these positions; do this -Depends?; Core RC Exercises; Scapular Stabilizers; Mvmt Awareness Drills

Scapular stabilizers/mvmt awareness
With RC Decompression, important is Education/Modify Activity; Posture – Frwd head, Shoulders; Address Tight Soft Tissues promoting aberrant mechanics; Modalities using palp positions; Mobilize Capsule -Depends?; Core RC Exercises; these muscles; these type Drills

0-150
In regards to elbow, normal ROM for flex/ext is this, for sup/pron 90/90; fxnal ROM for most ADL’s – flex/ext is 30-130, sup/pron is 50/50; fxnal ROM for all ADL’s – flex/ext is 15-140

30-130
In regards to elbow, normal ROM for flex/ext is 0-150, for sup/pron 90/90; fxnal ROM for most ADL’s – flex/ext is this, sup/pron is 50/50; fxnal ROM for all ADL’s – flex/ext is 15-140

50/50
In regards to elbow, normal ROM for flex/ext is 0-150, for sup/pron 90/90; fxnal ROM for most ADL’s – flex/ext is 30-130, sup/pron is this; fxnal ROM for all ADL’s – flex/ext is 15-140

15-140
In regards to elbow, normal ROM for flex/ext is 0-150, for sup/pron 90/90; fxnal ROM for most ADL’s – flex/ext is 30-130, sup/pron is 50/50; fxnal ROM for all ADL’s – flex/ext is this

Acute humeral shaft Fx
General mgmt for this: Conservative (non-surgical): Fracture brace (Sarmiento), Sling & swathe(cuff), Abduction pillow; Surgery: Plating/Intramedullary rod/External fixator

Fx brace/sling & swathe/abduction pillow
General mgmt for acute humeral shaft Fx: Conservative (non-surgical): these; Surgery: Plating/Intramedullary rod/External fixator

Plating/intramedullary rod/external fixator
General mgmt for acute humeral shaft Fx: Conservative (non-surgical): Fracture brace (Sarmiento), Sling & swathe(cuff), Abduction pillow; Surgery: these

Day 3-7
General mgmt for humeral Fx: Non-surgical: this time – Pendulum, Week 3-6 – A/AROM, Week -6-8 -AROM; Post op: 1st week – Pendulum, After 2 weeks- A/AROM, Week 3-4 – AROM

Pendulum/week 3-6
General mgmt for humeral Fx: Non-surgical: Day 3-7 – this, this time – A/AROM, Week -6-8 -AROM; Post op: 1st week – this, After 2 weeks- A/AROM, Week 3-4 – AROM

AAROM
General mgmt for humeral Fx: Non-surgical: Day 3-7 – Pendulum, Week 3-6 – this, Week -6-8 -AROM; Post op: 1st week – Pendulum, After 2 weeks- this, Week 3-4 – AROM

Week 6-8
General mgmt for humeral Fx: Non-surgical: Day 3-7 – Pendulum, Week 3-6 – A/AROM, this time -AROM; Post op: 1st week – Pendulum, After 2 weeks- A/AROM, Week 3-4 – AROM

Week 3-4
General mgmt for humeral Fx: Non-surgical: Day 3-7 – Pendulum, Week 3-6 – A/AROM, Week 6-8 -AROM; Post op: 1st week – Pendulum, After 2 weeks- A/AROM, this time – AROM

Elbow Fx
50% of UE injuries admitted to hospital are these; Presentation: Hx of trauma, Fat pad sign (effusion over olecranon), Inability to fully extend elbow, X-rays are gold standard; 2 Main Principles of Fx Mgmt: Promote stability, Regain functional mobility

Fat pad/effusion over olecranon
50% of UE injuries admitted to hospital are elbow Fx; Presentation: Hx of trauma, this sign (this), Inability to fully extend elbow, X-rays are gold standard; 2 Main Principles of Fx Mgmt: Promote stability, Regain functional mobility

Promote stability/regain fxnal mobility
50% of UE injuries admitted to hospital are elbow Fx; Presentation: Hx of trauma, Fat pad sign (effusion over olecranon), Inability to fully extend elbow, X-rays are gold standard; 2 Main Principles of Fx Mgmt: these

Supracondylar
This type Fx is most common pediatric elbow Fx – 80%; Extra -articular; Secondary to FOOSH; Tenderness noted over distal humerus; Casted in 90 degs, forearm neutral; Protected AROM at 3 weeks

Extra/FOOSH
Supracondylar Fx is most common pediatric elbow Fx – 80%; this type -articular; Secondary to this; Tenderness noted over distal humerus; Casted in 90 degs, forearm neutral; Protected AROM at 3 weeks

Distal humerus
Supracondylar Fx is most common pediatric elbow Fx – 80%; Extra -articular; Secondary to FOOSH; Tenderness noted over this; Casted in 90 degs, forearm neutral; Protected AROM at 3 weeks

90 degs/forearm neutral
Supracondylar Fx is most common pediatric elbow Fx – 80%; Extra -articular; Secondary to FOOSH; Tenderness noted over distal humerus; Casted in these positions; Protected AROM at 3 weeks

Protected AROM
Supracondylar Fx is most common pediatric elbow Fx – 80%; Extra -articular; Secondary to FOOSH; Tenderness noted over distal humerus; Casted in 90 degs, forearm neutral; this at 3 weeks

3 weeks
Supracondylar Fx is most common pediatric elbow Fx – 80%; Extra -articular; Secondary to FOOSH; Tenderness noted over distal humerus; Casted in 90 degs, forearm neutral; Protected AROM at this time

End of range
EOR

Intercondylar
These Fx usually require surgery; often “T” or “Y” shaped; high incidence of non-union; PT dependent on fixation but in general: Propensity for stiffness in flex/ext, not rotation; AROM asap (flexion but EOR extension avoided early); PRE’s at 8-12 wks p/o

T/Y
Intercondylar Fx usually require surgery; often shaped like one of these; high incidence of non-union; PT dependent on fixation but in general: Propensity for stiffness in flex/ext, not rotation; AROM asap (flexion but EOR extension avoided early); PRE’s at 8-12 wks p/o

Non-union/fixation
Intercondylar Fx usually require surgery; often “T” or “Y” shaped; high incidence of this; PT dependent on this but in general: Propensity for stiffness in flex/ext, not rotation; AROM asap (flexion but EOR extension avoided early); PRE’s at 8-12 wks p/o

Stiffness in flex/ext
Intercondylar Fx usually require surgery; often “T” or “Y” shaped; high incidence of non-union; PT dependent on fixation but in general: Propensity for this; AROM asap (flexion but EOR extension avoided early); PRE’s at 8-12 wks p/o

Rotation/AROM
Intercondylar Fx usually require surgery; often “T” or “Y” shaped; high incidence of non-union; PT dependent on fixation but in general: Propensity for stiffness in flex/ext, not this; this asap (flexion but EOR extension avoided early); PRE’s at 8-12 wks p/o

EOR extension
Intercondylar Fx usually require surgery; often “T” or “Y” shaped; high incidence of non-union; PT dependent on fixation but in general: Propensity for stiffness in flex/ext, not rotation; AROM asap (flexion but this avoided early); PRE’s at 8-12 wks p/o

8-12 weeks
Intercondylar Fx usually require surgery; often “T” or “Y” shaped; high incidence of non-union; PT dependent on fixation but in general: Propensity for stiffness in flex/ext, not rotation; AROM asap (flexion but EOR extension avoided early); PRE’s at this time post-op

Olecranon Fx ORIF
With this: Full elbow extension difficult to achieve, Persistent irritation from pins/screws, Metal fixation commonly removed

Full elbow extension
Olecranon Fx ORIF: this is difficult to achieve, Persistent irritation from pins/screws, Metal fixation commonly removed

Irritation from pins/screws
Olecranon Fx ORIF: Full elbow extension difficult to achieve, Persistent this, Metal fixation commonly removed

Removed
Olecranon Fx ORIF: Full elbow extension difficult to achieve, Persistent irritation from pins/screws, Metal fixation commonly this

Pediatric Forearm
These Fx are usually treated w/closed reduction; >85% closed reductions have satisfactory outcomes

Closed reduction
Pediatric Forearm Fx are usually treated w/this; >85% of these have satisfactory outcomes

>85
Pediatric Forearm Fx are usually treated w/closed reduction; this% closed reductions have satisfactory outcomes

Galeazzi
This Fx is of distal 1/3 radius & dislocation of distal radio-ulnar joint; Distal ulna often fractured; Tx is ORIF of radius/reduction of inferior radio-ulnar joint (LAC for 6-8 weeks); Will require physical therapy

Distal 1/3 radius
Galeazzi Fx is Fx of this & dislocation of distal radio-ulnar joint; Distal ulna often fractured; Tx is ORIF of radius/reduction of inferior radio-ulnar joint (LAC for 6-8 weeks); Will require physical therapy

Distal radio-ulnar joint dislocation
Galeazzi Fx is Fx of distal 1/3 radius & this; Distal ulna often fractured; Tx is ORIF of radius/reduction of inferior radio-ulnar joint (LAC for 6-8 weeks); Will require physical therapy

Fractured
Galeazzi Fx is Fx of distal 1/3 radius & dislocation of distal radio-ulnar joint; Distal ulna often this; Tx is ORIF of radius/reduction of inferior radio-ulnar joint (LAC for 6-8 weeks); Will require physical therapy

Radial ORIF/inferior radio-ulnar joint reduction
Galeazzi Fx is Fx of distal 1/3 radius & dislocation of distal radio-ulnar joint; Distal ulna often fractured; Tx is this (LAC for 6-8 weeks); Will require PT

LAC for 6-8 wks
Galeazzi Fx is Fx of distal 1/3 radius & dislocation of distal radio-ulnar joint; Distal ulna often fractured; Tx is ORIF of radius/reduction of inferior radio-ulnar joint (this); Will require PT

PT
Galeazzi Fx is Fx of distal 1/3 radius & dislocation of distal radio-ulnar joint; Distal ulna often fractured; Tx is ORIF of radius/reduction of inferior radio-ulnar joint (LAC for 6-8 weeks); Will require this

Dislocation
This Tx: Reduced in ER/MD office; Immobilized <1 week; PT Mgmt - (post reduction from MD); Early Active mvmt within pain free ROM; Edema mgmt - compression sleeves/garments & modalities if needed; Gripping/wrist flexion/extension; Strengthening; Avoid aggressive mobilization/forceful EOR extension

Reduced
Dislocation Tx: this in ER/MD office; Immobilized <1 week; PT Mgmt - (post reduction from MD); Early Active mvmt within pain free ROM; Edema mgmt - compression sleeves/garments & modalities if needed; Gripping/wrist flexion/extension; Strengthening; Avoid aggressive mobilization/forceful EOR extension

ER/MD office
Dislocation Tx: Reduced in these; Immobilized <1 week; PT Mgmt - (post reduction from MD); Early Active mvmt within pain free ROM; Edema mgmt - compression sleeves/garments & modalities if needed; Gripping/wrist flexion/extension; Strengthening; Avoid aggressive mobilization/forceful EOR extension

<1 week
Dislocation Tx: Reduced in ER/MD office; Immobilized this long; PT Mgmt – (post reduction from MD); Early Active mvmt within pain free ROM; Edema mgmt – compression sleeves/garments & modalities if needed; Gripping/wrist flexion/extension; Strength; Avoid aggressive mobilization/forceful EOR extension

Edema
Dislocation Tx: Reduced in ER/MD office; Immobilized <1 week; PT Mgmt - (post reduction from MD); Early Active mvmt within pain free ROM; this mgmt - compression sleeves/garments & modalities if needed; Gripping/wrist flexion/extension; Strengthening; Avoid aggressive mobilization/forceful EOR extension

Compression sleeves/garments/modalities
Dislocation Tx: Reduced in ER/MD office; Immobilized <1 week; PT Mgmt - (post reduction from MD); Early Active mvmt within pain free ROM; Edema mgmt - these if needed; Gripping/wrist flexion/extension; Strengthening; Avoid aggressive mobilization/forceful EOR extensio

Gripping/wrist flex/ext
Dislocation Tx: Reduced in ER/MD office; Immobilized <1 week; PT Mgmt - (post reduction from MD); Early Active mvmt within pain free ROM; Edema mgmt - compression sleeves/garments & modalities if needed; these mvmts; Strengthening; Avoid aggressive mobs/forceful EOR ext

Aggressive mobilization/forceful EOR ext
Dislocation Tx: Reduced in ER/MD office; Immobilized <1 week; PT Mgmt - (post reduction from MD); Early Active mvmt within pain free ROM; Edema mgmt - compression sleeves/garments & modalities if needed; Gripping/wrist flexion/extension; Strengthening; Avoid these

Valgus instability/UCL insufficiency
This happens when excessive valgus forces exceeds tensile strength causing micro tears, usually from overhead throwers; Acute – “pop”, single pitch; Insidious – overuse, after period of heavy throwing; Can become chronic; freq affected are overhead throwers

Excessive valgus force exceeds tensile strength
Valgus instability/UCL insufficiency happens when this occurs causing micro tears, usually from overhead throwers; Acute – “pop”, single pitch; Insidious – overuse, after period of heavy throwing; Can become chronic; freq affected are overhead throwers

Overhead throwers
Valgus instability/UCL insufficiency happens when excessive valgus forces exceeds tensile strength causing micro tears, usually from overhead throwers;
Acute – “pop”, single pitch; Insidious – overuse, after period of heavy throwing; Can become chronic; Most freq affected are these pt’s

Valgus instability/UCL insufficiency
This pathology conservative Tx: Complete rest 1-2 wks (or more) w/modalities as indicated; Slow/progressive strengthening; Isometrics; Eccentrics; Plyometrics; Interval throwing; Emphasize shoulder/scap stabilization/strength

Complete rest 1-2 wks or more
Valgus instability/UCL insufficiency conservative Tx: this w/modalities as indicated; Slow/progressive strengthening; Isometrics; Eccentrics; Plyometrics; Interval throwing; Emphasize shoulder/scap stabilization/strength

Slow/progressive
Valgus instability/UCL insufficiency conservative Tx: Complete rest 1-2 wks (or more) w/modalities as indicated; this type strengthening; Isometrics; Eccentrics; Plyometrics; Interval throwing; Emphasize shoulder/scap stabilization/strength

Isometrics/eccentrics/plyometrics/interval throwing
Valgus instability/UCL insufficiency conservative Tx: Complete rest 1-2 wks (or more) w/modalities as indicated; Slow/progressive strengthening; utilize these; Emphasize shoulder/scap stabilization/strength

Shoulder/scap stabilization/strength
Valgus instability/UCL insufficiency conservative Tx: Complete rest 1-2 wks (or more) w/modalities as indicated; Slow/progressive strengthening; Isometrics; Eccentrics; Plyometrics; Interval throwing; Emphasize these

UCL reconstruction
This may occur via Tommy John Surgery; Autograft w/tendon from: Palmaris Longus, Gracilis, Plantaris; 80% pitchers return to pitching; Address any joint pathology; nerve transposition if persistent motor or sensory Sx (40%)

Tommy John Surgery/autograft
UCL reconstruction may occur via this Tx; this of UCL w/tendon from: Palmaris Longus, Gracilis, Plantaris; Ulnar nerve is often dysfunctional (often re-routed to protect); 80% pitchers return to pitching; Address any joint pathology; Ulnar nerve transposition if persistent motor or sensory Sx (40%)

Palmaris Longus/Gracilis/Plantaris
UCL reconstruction may occur via Tommy John Surgery; Autograft of UCL w/tendon from these muscles; Ulnar nerve is often dysfunctional (often re-routed to protect); 80% pitchers return to pitching; Address any joint pathology; Ulnar nerve transposition if persistent motor or sensory Sx (40%)

Re-routed/80
UCL reconstruction may occur via Tommy John Surgery; Autograft of UCL w/tendon from: Palmaris Longus, Gracilis, Plantaris; Ulnar nerve is often dysfunctional (often this to protect); this% pitchers return to pitching; Address any joint pathology; Ulnar nerve transposition if persistent motor or sensory Sx (40%)

Persistent motor or sensory Sx/40
UCL reconstruction may occur via Tommy John Surgery; Autograft of UCL w/tendon from: Palmaris Longus, Gracilis, Plantaris; Ulnar nerve is often dysfunctional (often re-routed to protect); 80% pitchers return to pitching; Address any joint pathology; Ulnar nerve transposition if this (this%)

Arthroscopic/80-85
In regards to predicting RC pathology: Physical exam & this type exam show this% agreement (PTs); Some reports suggest shoulder clinical exams including special tests 91% sensitive, 75% specific; Thus a good clinical exam could lead you to a clinical diagnosis that is fairly accurate

91/75
In regards to predicting RC pathology: Physical exam & arthroscopic exam show 80-85% agreement (PTs); Some reports suggest shoulder clinical exams including special tests this% sensitive, this% specific; Thus a good clinical exam could lead you to a clinical diagnosis that is fairly accurate

Yes
Is ROM testing reliable AND valid for diagnosing RC pathology?

Reliability
Many of objective methods utilized to evaluate shoulder posture are poorly described, demonstrate inconsistent this & have limited evidence to suggest relationship btwn shoulder pain/posture; Common postural tests: Double Square, Lat. Scapular Slide, and Lenne Test.

Shoulder pain/posture
Many of objective methods utilized to evaluate shoulder posture are poorly described, demonstrate inconsistent reliability, & have limited evidence to suggest relationship btwn these; Common postural tests: Double Square, Lat. Scapular Slide, and Lenne Test.

Double Square/Lat Scap Slide/Lenne Test
Many of objective methods utilized to evaluate shoulder posture are poorly described, demonstrate inconsistent reliability, & have limited evidence to suggest relationship btwn shoulder pain/posture; Common postural tests: these

Supra/infraspinatus/subscap
At minimum, muscles that must be tested in pt’s w/suspected RC pathology: these; Very important to evaluate scapular muscle strength to include serratus, middle trap, and lower trap

Scapular
At minimum, muscles that must be tested in pt’s w/suspected RC pathology: SS/IS/SuS; Very important to evaluate these muscle strengths to include serratus, middle trap, and lower trap

Serratus/mid/low trap
At minimum, muscles that must be tested in pt’s w/suspected RC pathology: SS/IS/SuS; Very important to evaluate scapular muscle strength to include these

Drop arm
Note about this test: Very similar to SS muscle test, in fact this test is basically a test to determine if a patient has an MMT of the greater or less than 3/5. Pain is also a factor to consider in some patients; Sensitivity = 8%, Specificity = 97%, Reliability = not reported

Supraspinatus
Note about the Drop Arm test: Very similar to this muscle test, in fact the drop arm test is basically a test to determine if a patient has an MMT of the greater or less than 3/5. Pain is also a factor to consider in some patients; Sensitivity = 8%, Specificity = 97%, Reliability = not reported

3/5
Note about the Drop Arm test: Very similar to SS muscle test, in fact the drop arm test is basically a test to determine if a patient has an MMT of the greater or less than this. Pain is also a factor to consider in some patients; Sensitivity = 8%, Specificity = 97%, Reliability = not reported

Specificity
Note about the Drop Arm test: Very similar to SS muscle test, in fact the drop arm test is basically a test to determine if a patient has an MMT of the greater or less than 3/5. Pain is also a factor to consider in some patients; Better Sensitivity or Specificity?

Sensitivity
In regards to SS MMT: Empty Can – better sensitivity or specificity? Full Can – Sensitivity – 77%, Specificity – 74%

86
In regards to SS MMT: Empty Can – Sensitivity – this%, Specificity – 50%; Full Can – Sensitivity – 77%, Specificity – 74%

50
In regards to SS MMT: Empty Can – Sensitivity – 86%, Specificity – this%; Full Can – Sensitivity – 77%, Specificity – 74%

Sensitivity slightly
In regards to SS MMT: Empty Can – Sensitivity – 86%, Specificity – 50%; Full Can – better sensitivity or specificity?

77
In regards to SS MMT: Empty Can – Sensitivity – 86%, Specificity – 50%; Full Can – Sensitivity – this%, Specificity – 74%

74
In regards to SS MMT: Empty Can – Sensitivity – 86%, Specificity – 50%; Full Can – Sensitivity – 77%, Specificity – this%

Standing
EMG Studies Suggest this ER MMT position as optimal for testing infraspinatus, no sensitivity or specificity data;
The Drop Sign – Sensitivity – 100%, Specificity – 100%, Irreparable Infraspinatus tears

Infraspinatus
EMG Studies Suggest standing ER MMT position as optimal for testing this, no sensitivity or specificity data;
The Drop Sign – Sensitivity – 100%, Specificity – 100%, Irreparable this tears

Drop sign
EMG Studies Suggest standing ER MMT position as optimal for testing infraspinatus, no sensitivity or specificity data;
This – Sensitivity – 100%, Specificity – 100%, Irreparable Infraspinatus tears

100
EMG Studies Suggest standing ER MMT position as optimal for testing infraspinatus, no sensitivity or specificity data;
The Drop Sign – Sensitivity/Specificity both this%, Irreparable Infraspinatus tears

Irreparable
EMG Studies Suggest standing ER MMT position as optimal for testing infraspinatus, no sensitivity or specificity data;
The Drop Sign – Sensitivity – 100%, Specificity – 100%, these type Infraspinatus tears

ER Lag
This Sign (Infra/Supraspinatus rupture test), Purpose: Detecting supra/infraspinatus tear; Sensitivity = 70%, Specificity = 100%, Reliability = not reported

Infra/supraspinatus rupture
ER Lag Sign (this test), Purpose: Detecting supra/infraspinatus tear; Sensitivity = 70%, Specificity = 100%, Reliability = not reported

Detecting supra/infraspinatus tear
ER Lag Sign (Infra/Supraspinatus rupture test), Purpose: this; Sensitivity = 70%, Specificity = 100%, Reliability = not reported

70
ER Lag Sign (Infra/Supraspinatus rupture test), Purpose: Detecting supra/infraspinatus tear; Sensitivity = this%, Specificity = 100%, Reliability = not reported

100
ER Lag Sign (Infra/Supraspinatus rupture test), Purpose: Detecting supra/infraspinatus tear; Sensitivity = 70%, Specificity = this%, Reliability = not reported

Specificity
ER Lag Sign (Infra/Supraspinatus rupture test), Purpose: Detecting supra/infraspinatus tear; better sensitivity or specificity?

Lift off
This test (subscap rupture test): Sensitivity – 80%, Specificity – 100% for tear of subscapularis muscle

Specificity
Lift Off test (subscap rupture test): better sensitivity or specificity?

80
Lift Off test (subscap rupture test): Sensitivity – this%, Specificity – 100% for tear of subscapularis muscle

100
Lift Off test (subscap rupture test): Sensitivity – 80%, Specificity – this% for tear of subscapularis muscle

T-spine extension
If you don’t have good this, you’ll reach impingement sooner w/shoulder flexion

Shoulder flexion
If you don’t have good T-spine ext, you’ll reach impingement sooner w/this

IR Lag
This Sign (SuS rupture test) Purpose: Detecting subscapularis rupture – massive RCT; Sensitivity = 97%, Specificity = 96%, Reliability = not reported; Note: The lift off sign (very similar test) has a sensitivity of 62% and specificity of 100%

Massive RCT/97
IR Lag Sign (SuS rupture test) Purpose: Detecting subscapularis rupture – this; Sensitivity = this%, Specificity = 96%, Reliability = not reported; Note: The lift off sign (very similar test) has a sensitivity of 62% and specificity of 100%

96/lift off
IR Lag Sign (SuS rupture test) Purpose: Detecting subscapularis rupture – massive RCT; Sensitivity = 97%, Specificity = this%, Reliability = not reported; Note: This sign (very similar test) has a sensitivity of 62% and specificity of 100%

100
IR Lag Sign (SuS rupture test) Purpose: Detecting subscapularis rupture – massive RCT; Sensitivity = 97%, Specificity = 96%, Reliability = not reported; Note: The lift off sign (very similar test) has a sensitivity of 62% and specificity of this%

62
IR Lag Sign (SuS rupture test) Purpose: Detecting subscapularis rupture – massive RCT; Sensitivity = 97%, Specificity = 96%, Reliability = not reported; Note: The lift off sign (very similar test) has a sensitivity of this% and specificity of 100%

82
This% of the time diminished reflexes correlate w/surgical findings & diminished reflexes correlated 65% of the time.

Diminished reflexes
82 % of the time these correlate w/surgical findings & these correlated 65% of the time.

Surgical findings
82 % of the time diminished reflexes correlate w/these & diminished reflexes correlated 65% of the time.

65
82 % of the time diminished reflexes correlate w/surgical findings & diminished reflexes correlated this% of the time.

60
Scaption should only go up to about this many degs for therapy, after that the deltoids are mostly working

AC capsule
AC joint Injury is caused by force applied to acromion (fall on superior aspect); this disrupted; Corococlavicular ligs disrupted (conoid and trapezoid); “Shoulder separation” relates to AC joint NOT SC joint

Disrupted/coroclavicular ligs
AC joint Injury is caused by force applied to acromion (fall on superior aspect); AC capsule is this; these disrupted; “Shoulder separation” relates to AC joint NOT SC joint

Shoulder separation
AC joint Injury is caused by force applied to acromion (fall on superior aspect); AC capsule disrupted; Corococlavicular ligs disrupted (conoid and trapezoid); “this” relates to AC joint NOT SC joint

I-III
These grades of AC joint injury are most commonly seen by PT

Some injury to CC ligs
Grades of AC joint injury: Grade I (incomplete tear of ligs), II (partial tear of AC ligs, may have this), III (complete tear of AC/CC ligs), IV (posterior position of clavicle), V (major subluxation, skin at risk), VI (inferior displacement of clavicle); Grades I-III most commonly seen by PT

Complete tear of AC/CC ligs
Grades of AC joint injury: Grade I (incomplete tear of ligs), II (partial tear of AC ligs, may have some injury to CC ligs), III (this), IV (posterior position of clavicle), V (major subluxation, skin at risk), VI (inferior displacement of clavicle); Grades I-III most commonly seen by PT

Post position of clavicle
Grades of AC joint injury: Grade I (incomplete tear of ligs), II (partial tear of AC ligs, may have some injury to CC ligs), III (complete tear of AC/CC ligs), IV (this), V (major subluxation, skin at risk), VI (inferior displacement of clavicle); Grades I-III most commonly seen by PT

Major subluxation/skin at risk
Grades of AC joint injury: Grade I (incomplete tear of ligs), II (partial tear of AC ligs, may have some injury to CC ligs), III (complete tear of AC/CC ligs), IV (posterior position of clavicle), V (this), VI (inferior displacement of clavicle); Grades I-III most commonly seen by PT

Inf displacement of clavicle
Grades of AC joint injury: Grade I (incomplete tear of ligs), II (partial tear of AC ligs, may have some injury to CC ligs), III (complete tear of AC/CC ligs), IV (posterior position of clavicle), V (major subluxation, skin at risk), VI (this); Grades I-III most commonly seen by PT

3-4 weeks
When treating Grades I/II AC joint injuries, pt will generally feel good in this amt of time

Lateral epicondylitis
Mgmt of this: Modalities – thermal (within 1st 6 weeks), Moderate evidence; Modalities – US or phonophoresis, Conflicting evidence; Modalities – Iontophoresis or TENS, Weak evidence; Dry Needling, Weak evidence; Ergonomics, Little evidence pertaining specifically to LE

Thermal/1st 6 weeks
Mgmt of Lateral Epicondylitis: Modalities – this (in this time), Moderate evidence; Modalities – US or phonophoresis, Conflicting evidence; Modalities – Iontophoresis or TENS, Weak evidence; Dry Needling, Weak evidence; Ergonomics, Little evidence pertaining specifically to condition

Moderate
Mgmt of Lateral Epicondylitis: Modalities – thermal (within 1st 6 weeks), this level evidence; Modalities – US or phonophoresis, Conflicting evidence; Modalities – Iontophoresis or TENS, Weak evidence; Dry Needling, Weak evidence; Ergonomics, Little evidence pertaining specifically to condition

US/phonophoresis
Mgmt of Lateral Epicondylitis: Modalities – thermal (within 1st 6 weeks), Moderate evidence; Modalities – one of these, Conflicting evidence; Modalities – Iontophoresis or TENS, Weak evidence; Dry Needling, Weak evidence; Ergonomics, Little evidence pertaining specifically to condition

Conflicting
Mgmt of Lateral Epicondylitis: Modalities – thermal (within 1st 6 weeks), Moderate evidence; Modalities – US or phonophoresis, this level evidence; Modalities – Iontophoresis or TENS, Weak evidence; Dry Needling, Weak evidence; Ergonomics, Little evidence pertaining specifically to condition

Iontophoresis/TENS
Mgmt of Lateral Epicondylitis: Modalities – thermal (within 1st 6 weeks), Moderate evidence; Modalities – US or phonophoresis, Conflicting evidence; Modalities – one of these, Weak evidence; Dry Needling, Weak evidence; Ergonomics, Little evidence pertaining specifically to condition

Weak/dry needling
Mgmt of Lateral Epicondylitis: Modalities – thermal (within 1st 6 weeks), Moderate evidence; Modalities – US or phonophoresis, Conflicting evidence; Modalities – Iontophoresis or TENS, this level evidence; this, Weak evidence; Ergonomics, Little evidence pertaining specifically to condition

Weak
Mgmt of Lateral Epicondylitis: Modalities – thermal (within 1st 6 weeks), Moderate evidence; Modalities – US or phonophoresis, Conflicting evidence; Modalities – Iontophoresis or TENS, Weak evidence; Dry Needling, this level evidence; Ergonomics, Little evidence pertaining specifically to condition

Ergonomics
Mgmt of Lateral Epicondylitis: Modalities – thermal (within 1st 6 weeks), Moderate evidence; Modalities – US or phonophoresis, Conflicting evidence; Modalities – Iontophoresis or TENS, Weak evidence; Dry Needling, Weak evidence; this, Little evidence pertaining specifically to condition

Lateral Epicondylitis
This condition Operative Tx: Failed non-operative Tx for 1 year (Depends on compliance/severity); Higher likelihood of success (Localized/specific physical findings, Affects ADL’s, Relief w/injection); Avoid surgery (Poor localization, Mild pain only w/sports, No improvement w/injection)

1 year
Lateral Epicondylitis Operative Tx: Failed non-operative Tx for this long (Depends on compliance/severity); Higher likelihood of success (Localized/specific physical findings, Affects ADL’s, Relief w/injection); Avoid surgery (Poor localization, Mild pain only w/sports, No improvement w/injection)

Compliance/severity
Lateral Epicondylitis Operative Tx: Failed non-operative Tx for 1 year (Depends on these); Higher likelihood of success (Localized/specific physical findings, Affects ADL’s, Relief w/injection); Avoid surgery (Poor localization, Mild pain only w/sports, No improvement w/injection)

Localized/specific physical
Lateral Epicondylitis Operative Tx: Failed non-operative Tx for 1 year (Depends on compliance/severity); Higher likelihood of success (these type findings, Affects ADL’s, Relief w/injection); Avoid surgery (Poor localization, Mild pain only w/sports, No improvement w/injection)

ADLs/injection
Lateral Epicondylitis Operative Tx: Failed non-operative Tx for 1 year (Depends on compliance/severity); Higher likelihood of success (Localized/specific physical findings, Affects these, Relief w/this); Avoid surgery (Poor localization, Mild pain only w/sports, No improvement w/this)

Localization/sports
Lateral Epicondylitis Operative Tx: Failed non-operative Tx for 1 year (Depends on compliance/severity); Higher likelihood of success (Localized/specific physical findings, Affects ADL’s, Relief w/injection); Avoid surgery (Poor this, Mild pain only w/these, No improvement w/injection)

Mild
Lateral Epicondylitis Operative Tx: Failed non-operative Tx for 1 year (Depends on compliance/severity); Higher likelihood of success (Localized/specific physical findings, Affects ADL’s, Relief w/injection); Avoid surgery (Poor localization, this level pain only w/sports, No improve w/injection)

Medial epicondylitis
Diff Dx w/this condition: Nerve root compression (C7-T1), TOS, Referred from shoulder, Ulnar nerve injury/neuropathy, Medial elbow instability, UCL Strain

C7-T1
Diff Dx w/Medial Epicondylitis: Nerve root compression (these specifically), TOS, Referred from shoulder, Ulnar nerve injury/neuropathy, Medial elbow instability, UCL Strain

TOS
Diff Dx w/Medial Epicondylitis: Nerve root compression (C7-T1), this, Referred from shoulder, Ulnar nerve injury/neuropathy, Medial elbow instability, UCL Strain

Shoulder
Diff Dx w/Medial Epicondylitis: Nerve root compression (C7-T1), TOS, Referred from this, Ulnar nerve injury/neuropathy, Medial elbow instability, UCL Strain

Instability
Diff Dx w/Medial Epicondylitis: Nerve root compression (C7-T1), TOS, Referred from shoulder, Ulnar nerve injury/neuropathy, Medial elbow this, UCL Strain

UCL
Diff Dx w/Medial Epicondylitis: Nerve root compression (C7-T1), TOS, Referred from shoulder, Ulnar nerve injury/neuropathy, Medial elbow instability, this Strain

Elongate/slide/translate
Nerves require ability to do these, if not then peripheral neuropathy may occur; Ulnar nerve may be compressed in Cubital tunnel – most common compression site or Guyon’s canal in wrist; Median nerve may lead to Pronator Syndrome/Carpal Tunnel Syndrome; Radial nerve may be compressed at Humeral shaft/Radial Tunnel

Cubital tunnel
Nerves require ability to elongate/slide/translate, if not then peripheral neuropathy may occur; Ulnar nerve may be compressed in this – most common compression site or Guyon’s canal in wrist; Median nerve may lead to Pronator Syndrome/Carpal Tunnel Syndrome; Radial nerve may be compressed at Humeral shaft/Radial Tunnel

Guyons canal
Nerves require ability to elongate/slide/translate, if not then peripheral neuropathy may occur; Ulnar nerve may be compressed in Cubital tunnel – most common compression site or this in wrist; Median nerve may lead to Pronator Syndrome/Carpal Tunnel Syndrome; Radial nerve may be compressed at Humeral shaft/Radial Tunnel

Carpal Tunnel/Pronator Syndrome
Nerves require ability to elongate/slide/translate, if not then peripheral neuropathy may occur; Ulnar nerve may be compressed in Cubital tunnel – most common compression site or Guyon’s canal in wrist; Median nerve may lead to these conditions; Radial nerve may be compressed at Humeral shaft/Radial Tunnel

Humeral shaft/radial tunnel
Nerves require ability to elongate/slide/translate, if not then peripheral neuropathy may occur; Ulnar nerve may be compressed in Cubital tunnel – most common compression site or Guyon’s canal in wrist; Median nerve may lead to Pronator Syndrome/Carpal Tunnel Syndrome; Radial nerve may be compressed at these

Ulnar neuropathy/Cubital Tunnel syndrome
With this condition, position is important; Intraneural Pressure changes (Elbow flexion increases pressure on this 3x, Add shoulder abduction/wrist extension & pressure increases 6x, Add dynamic FCU contraction & pressure increases 20x)

Position
With Ulnar neuropathy/Cubital Tunnel Syndrome, this is important; Intraneural Pressure changes (Elbow flexion increases pressure on ulnar nerve 3x, Add shoulder abduction/wrist extension & pressure increases 6x, Add dynamic FCU contraction & pressure increases 20x)

Intraneural pressure/elbow flex
With Ulnar neuropathy/Cubital Tunnel Syndrome, position is important; these type changes (this increases pressure on ulnar nerve 3x, Add shoulder abduction/wrist extension & pressure increases 6x, Add dynamic FCU contraction & pressure increases 20x)

3x
With Ulnar neuropathy/Cubital Tunnel Syndrome, position is important; Intraneural Pressure changes (Elbow flexion increases pressure on ulnar nerve this much, Add shoulder abduction/wrist extension & pressure increases 6x, Add dynamic FCU contraction & pressure increases 20x)

Should abduction/wrist ext
With Ulnar neuropathy/Cubital Tunnel Syndrome, position is important; Intraneural Pressure changes (Elbow flexion increases pressure on ulnar nerve 3x, Add these & pressure increases 6x, Add dynamic FCU contraction & pressure increases 20x)

6x/dynamic FCU contraction
With Ulnar neuropathy/Cubital Tunnel Syndrome, position is important; Intraneural Pressure changes (Elbow flexion increases pressure on ulnar nerve 3x, Add shoulder abduction/wrist extension & pressure increases this much, Add this & pressure increases 20x)

20x
With Ulnar neuropathy/Cubital Tunnel Syndrome, position is important; Intraneural Pressure changes (Elbow flexion increases pressure on ulnar nerve 3x, Add shoulder abduction/wrist extension & pressure increases 6x, Add dynamic FCU contraction & pressure increases this much)

Cubital Tunnel Surgery
This is used to release compression; Transposition of nerve out of groove nerve & move anteriorly – submuscular or subcutaneous; “hourglass” appearance often observed

Pronator Teres Syndrome
This is injury to the median nerve in the forearm resulting in sensory changes, muscle weakness and/or complete paralysis.

Median
Pronator Teres Syndrome is injury to this nerve in the forearm resulting in sensory changes, muscle weakness and/or complete paralysis.

Complete paralysis
Pronator Teres Syndrome is injury to the median nerve in the forearm resulting in sensory changes, muscle weakness and/or this

Release compression
Cubital Tunnel Surgery: used to do this; Transposition of nerve out of groove nerve & move anteriorly – submuscular or subcutaneous; “hourglass” appearance often observed

Anterior
Cubital Tunnel Surgery: used to release compression; Transposition of nerve out of groove nerve & move this direction – submuscular or subcutaneous; “hourglass” appearance often observed

Hourglass
Cubital Tunnel Surgery: used to release compression; Transposition of nerve out of groove nerve & move anteriorly – submuscular or subcutaneous; “this” appearance often observed

Either
Cubital Tunnel Surgery: used to release compression; Transposition of nerve out of groove nerve & move anteriorly – submuscular or subcutaneous?

Pain/ache
AIN syndrome S/S: one of these in proximal forearm (volar), especially w/resisted pronation; If progressed, atrophy in mid-forearm flexors; No sensory distribution – motor Sx only; Hallmark sign – Can’t flex thumb IP or IF DIP (can’t make OK sign)

Prox forearm
AIN syndrome S/S: Pain or ache in this, especially w/resisted pronation; If progressed, atrophy in mid-forearm flexors; No sensory distribution – motor Sx only; Hallmark sign – Can’t flex thumb IP or IF DIP (can’t make OK sign)

Volar
AIN syndrome S/S: Pain or ache in proximal forearm (this side), especially w/resisted pronation; If progressed, atrophy in mid-forearm flexors; No sensory distribution – motor Sx only; Hallmark sign – Can’t flex thumb IP or IF DIP (can’t make OK sign)

Resisted pronation/mid-forearm flexors atrophy
AIN syndrome S/S: Pain or ache in proximal forearm (volar), especially w/this; If progressed, this; No sensory distribution – motor Sx only; Hallmark sign – Can’t flex thumb IP or IF DIP (can’t make OK sign)

Sensory distribution
AIN syndrome S/S: Pain or ache in proximal forearm (volar), especially w/resisted pronation; If progressed, atrophy in mid-forearm flexors; No this; Hallmark sign – Can’t flex thumb IP or IF DIP (can’t make OK sign)

Flex thumb IP or IF DIP/make OK sign
AIN syndrome S/S: Pain or ache in proximal forearm (volar), especially w/resisted pronation; If progressed, atrophy in mid-forearm flexors; No sensory distribution – motor Sx only; Hallmark sign – Can’t do this

Radial n entrapment
This condition S/S: Achy pain at Radial tunnel, supinator mass, or proximal extensor mass; Pain extending to lateral epicondyle; Long finger resistance test may be positive; Occassional weakness extensors of thumb, APL & EIP; Counterforce tennis elbow straps may increase Sx; No sensory loss

Aching pain
Radial Nerve entrapment S/S: this at Radial tunnel, supinator mass, or prox extensor mass; Pain extending to lateral epicondyle; Long finger resistance test may be positive; Occassional weakness extensors of thumb, APL & EIP; Counterforce tennis elbow straps may increase Sx; No sensory loss

Radial tunnel/supinator mass/proximal extensor mass
Radial Nerve entrapment S/S: Aching pain at one of these; Pain extending to lateral epicondyle; Long finger resistance test may be positive; Occassional weakness extensors of thumb, APL & EIP; Counterforce tennis elbow straps may increase Sx; No sensory loss

Lateral epicondyle
Radial Nerve entrapment S/S: Aching pain at Radial tunnel, supinator mass, or proximal extensor mass; Pain extending to this; Long finger resistance test may be positive; Occassional weakness extensors of thumb, APL & EIP; Counterforce tennis elbow straps may increase Sx; No sensory loss

Lateral epicondyle/long finger resistance
Radial Nerve entrapment S/S: Aching pain at Radial tunnel, supinator mass, or proximal extensor mass; Pain extending to this; this test may be positive; Occassional weakness extensors of thumb, APL & EIP; Counterforce tennis elbow straps may increase Sx; No sensory loss

Thumb ext/APL/EIP
Radial Nerve entrapment S/S: Aching pain at Radial tunnel, supinator mass, or proximal extensor mass; Pain extending to lateral epicondyle; Long finger resistance test may be positive; Occassional weakness of these; Counterforce tennis elbow straps may increase Sx; No sensory loss

Counterforce tennis elbow straps/sensory loss
Radial Nerve entrapment S/S: Aching pain at Radial tunnel, supinator mass, or proximal extensor mass; Pain extending to lateral epicondyle; Long finger resistance test may be positive; Occassional weakness extensors of thumb, APL & EIP; these may increase Sx; No this

Radial nerve palsy
PT mgmt for this: Prevent contracture, Splint for function, Often spontaneous recovery 12 weeks

Contracture
PT mgmt for Radial Nerve palsy: Prevent this, Splint for function, Often spontaneous recovery 12 weeks

Splint
PT mgmt for Radial Nerve palsy: Prevent contracture, do this for function, Often spontaneous recovery 12 weeks

12 weeks
PT mgmt for Radial Nerve palsy: Prevent contracture, Splint for function, Often spontaneous recovery in this time

Spontaneous
PT mgmt for Radial Nerve palsy: Prevent contracture, Splint for function, Often this type recovery 12 weeks

Total Elbow Arthroplasty
This intervention Goal – stable joint w/painless ROM w/ADLs; Strict indications – advanced age, low physical demand, chronic instability, advanced RA, posttraumatic OA, severe stiffness & pain; Indicated for pts older than 65 for whom other Tx have failed & who are willing to comply w/post-op restrictions; Complications: Instability, Loosening, Ulnar nerve irritation (30% reported), Infection

Stable joint w/painless ROM w/ADLs
Total Elbow Arthroplasty Goal – this; Strict indications – advanced age, low physical demand, chronic instability, advanced RA, posttraumatic OA, severe stiffness & pain; Indicated for pts older than 65 for whom other Tx have failed & who are willing to comply w/post-op restrictions; Complications: Instability, Loosening, Ulnar nerve irritation (30% reported), Infection

Strict
Total Elbow Arthroplasty Goal – stable joint w/painless ROM w/ADLs; these type indications – advanced age, low physical demand, chronic instability, advanced RA, posttraumatic OA, severe stiffness & pain; Indicated for pts older than 65 for whom other Tx have failed & who are willing to comply w/post-op restrictions; Complications: Instability, Loosening, Ulnar nerve irritation (30% reported), Infection

Advanced age/low physical demand/chronic instability
Total Elbow Arthroplasty Goal – stable joint w/painless ROM w/ADLs; Strict indications – these, advanced RA, posttraumatic OA, severe stiffness & pain; Indicated for pts older than 65 for whom other Tx have failed & who are willing to comply w/post-op restrictions; Complications: Instability, Loosening, Ulnar nerve irritation (30% reported), Infection

Advanced
Total Elbow Arthroplasty Goal – stable joint w/painless ROM w/ADLs; Strict indications – advanced age, low physical demand, chronic instability, this type RA, posttraumatic OA, severe stiffness & pain; Indicated for pts older than 65 for whom other Tx have failed & who are willing to comply w/post-op restrictions; Complications: Instability, Loosening, Ulnar nerve irritation (30% reported), Infection

Posttraumatic
Total Elbow Arthroplasty Goal – stable joint w/painless ROM w/ADLs; Strict indications – advanced age, low physical demand, chronic instability, advanced RA, this type OA, severe stiffness & pain; Indicated for pts older than 65 for whom other Tx have failed & who are willing to comply w/post-op restrictions; Complications: Instability, Loosening, Ulnar nerve irritation (30% reported), Infection

Severe stiffness/pain
Total Elbow Arthroplasty Goal – stable joint w/painless ROM w/ADLs; Strict indications – advanced age, low physical demand, chronic instability, advanced RA, posttraumatic OA, these; Indicated for pts older than 65 for whom other Tx have failed & who are willing to comply w/post-op restrictions; Complications: Instability, Loosening, Ulnar nerve irritation (30% reported), Infection

Instability/loosening/ulnar n irritation/infection
Total Elbow Arthroplasty Goal – stable joint w/painless ROM w/ADLs; Strict indications – advanced age, low physical demand, chronic instability, advanced RA, posttraumatic OA, severe stiffness & pain; Indicated for pts older than 65 for whom other Tx have failed & who are willing to comply w/post-op restrictions; Complications: these

30
Total Elbow Arthroplasty Goal – stable joint w/painless ROM w/ADLs; Strict indications – advanced age, low physical demand, chronic instability, advanced RA, posttraumatic OA, severe stiffness & pain; Indicated for pts older than 65 for whom other Tx have failed & who are willing to comply w/post-op restrictions; Complications: Instability, Loosening, Ulnar nerve irritation (this% reported), Infection

Distal radius Fx
This etiology: FOOSH/MVA/direct trauma

FOOSH/MVA/direct trauma
Distal radius Fx etiology: these

Distal radius
These Fx Types: Colles- most common this type Fx (dorsal angulation – causes “dinner fork deformity” -fall w/wrist extended), Smith’s-volar angulation (“Reverse Colles”; fall w/wrist flexed), Barton’s-displaced, unstable Fx (carpal displacement w/fragment of radius distinguishes from Colle’s and Smith’s; fall on extended wrist and pronated forearm)

Colles
Distal Radius Fx Types: this- most common distal radius Fx (dorsal angulation – causes “dinner fork deformity” -fall w/wrist extended), Smith’s-volar angulation (“Reverse this”; fall w/wrist flexed), Barton’s-displaced, unstable Fx (carpal displacement w/fragment of radius distinguishes from this and Smith’s; fall on extended wrist and pronated forearm)

Dorsal/dinner fork deformity
Distal Radius Fx Types: Colles- most common distal radius Fx (this angulation – causes “this” -fall w/wrist extended), Smith’s-volar angulation (“Reverse Colles”; fall w/wrist flexed), Barton’s-displaced, unstable Fx (carpal displacement w/fragment of radius distinguishes from Colle’s and Smith’s; fall on extended wrist and pronated forearm)

Smiths
Distal Radius Fx Types: Colles- most common distal radius Fx (dorsal angulation – causes “dinner fork deformity” -fall w/wrist extended), this-volar angulation (“Reverse Colles”; fall w/wrist flexed), Barton’s-displaced, unstable Fx (carpal displacement w/fragment of radius distinguishes from Colle’s and this; fall on extended wrist and pronated forearm)

Volar/reverse colles
Distal Radius Fx Types: Colles- most common distal radius Fx (dorsal angulation – causes “dinner fork deformity” -fall w/wrist extended), Smith’s-this angulation (“this”; fall w/wrist flexed), Barton’s-displaced, unstable Fx (carpal displacement w/fragment of radius distinguishes from Colle’s and Smith’s; fall on extended wrist and pronated forearm)

Bartons
Distal Radius Fx Types: Colles- most common distal radius Fx (dorsal angulation – causes “dinner fork deformity” -fall w/wrist extended), Smith’s-volar angulation (“Reverse Colles”; fall w/wrist flexed), this-displaced, unstable Fx (carpal displacement w/fragment of radius distinguishes from Colle’s and Smith’s; fall on extended wrist and pronated forearm)

Displaced/unstable
Distal Radius Fx Types: Colles- most common distal radius Fx (dorsal angulation – causes “dinner fork deformity” -fall w/wrist extended), Smith’s-volar angulation (“Reverse Colles”; fall w/wrist flexed), Barton’s-this type Fx (carpal displacement w/fragment of radius distinguishes from Colle’s and Smith’s; fall on extended wrist and pronated forearm)

Carpal/fragment
Distal Radius Fx Types: Colles- most common distal radius Fx (dorsal angulation – causes “dinner fork deformity” -fall w/wrist extended), Smith’s-volar angulation (“Reverse Colles”; fall w/wrist flexed), Barton’s-displaced, unstable Fx (this displacement w/this of radius distinguishes from Colle’s and Smith’s; fall on extended wrist and pronated forearm)

Ext wrist/pronated forearm
Distal Radius Fx Types: Colles- most common distal radius Fx (dorsal angulation – causes “dinner fork deformity” -fall w/wrist extended), Smith’s-volar angulation (“Reverse Colles”; fall w/wrist flexed), Barton’s-displaced, unstable Fx (carpal displacement w/fragment of radius distinguishes from Colle’s and Smith’s; fall on these)

Post-op
Distal Radial Fx Tx (usually this): Modalities: moist heat, paraffin, may use TENS or fluidotherapy; AROM of all involved joints (intrinsic stretching, tendon gliding, isolate wrist extensors), HEP-active ROM addressing all involved joints, use splint at night to keep wrist neutral if joint is painful or has numbness/tingling, keep elevated if edema persists, if using bivalve splint teach don/doff & wear/care

Moist heat/paraffin
Distal Radial Fx Tx (usually post-op): Modalities: these, may use TENS or fluidotherapy; AROM of all involved joints (intrinsic stretching, tendon gliding, isolate wrist extensors), HEP-active ROM addressing all involved joints, use splint at night to keep wrist neutral if joint is painful or has numbness/tingling, keep elevated if edema persists, if using bivalve splint teach don/doff & wear/care

TENS/fluidotherapy
Distal Radial Fx Tx (usually post-op): Modalities: moist heat, paraffin, may use either of these; AROM of all involved joints (intrinsic stretching, tendon gliding, isolate wrist extensors), HEP-active ROM addressing all involved joints, use splint at night to keep wrist neutral if joint is painful or has numbness/tingling, keep elevated if edema persists, if using bivalve splint teach don/doff & wear/care

AROM
Distal Radial Fx Tx (usually post-op): Modalities: moist heat, paraffin, may use TENS or fluidotherapy; this of all involved joints (intrinsic stretching, tendon gliding, isolate wrist extensors), HEP-active ROM addressing all involved joints, use splint at night to keep wrist neutral if joint is painful or has numbness/tingling, keep elevated if edema persists, if using bivalve splint teach don/doff & wear/care

Intrinsic stretching/tendon gliding/isolate wrist extensors
Distal Radial Fx Tx (usually post-op): Modalities: moist heat, paraffin, may use TENS or fluidotherapy; AROM of all involved joints (these interventions), HEP-active ROM addressing all involved joints, use splint at night to keep wrist neutral if joint is painful or has numbness/tingling, keep elevated if edema persists, if using bivalve splint teach don/doff & wear/care

AROM
Distal Radial Fx Tx (usually post-op): Modalities: moist heat, paraffin, may use TENS or fluidotherapy; AROM of all involved joints (intrinsic stretching, tendon gliding, isolate wrist extensors), HEP-this addressing all involved joints, use splint at night to keep wrist neutral if joint is painful or has numbness/tingling, keep elevated if edema persists, if using bivalve splint teach don/doff & wear/care

Painful/numbness/tingling
Distal Radial Fx Tx (usually post-op): Modalities: moist heat, paraffin, may use TENS or fluidotherapy; AROM of all involved joints (intrinsic stretching, tendon gliding, isolate wrist extensors), HEP-active ROM addressing all involved joints, use splint at night to keep wrist neutral if joint is one of these, keep elevated if edema persists, if using bivalve splint teach don/doff & wear/care

Splint/neutral
Distal Radial Fx Tx (usually post-op): Modalities: moist heat, paraffin, may use TENS or fluidotherapy; AROM of all involved joints (intrinsic stretching, tendon gliding, isolate wrist extensors), HEP-active ROM addressing all involved joints, use this at night to keep wrist in this position if joint is painful or has numbness/tingling, keep elevated if edema persists, if using bivalve splint teach don/doff & wear/care

Elevated/edema
Distal Radial Fx Tx (usually post-op): Modalities: moist heat, paraffin, may use TENS or fluidotherapy; AROM of all involved joints (intrinsic stretching, tendon gliding, isolate wrist extensors), HEP-active ROM addressing all involved joints, use splint at night to keep wrist neutral if joint is painful or has numbness/tingling, keep this if this persists, if using bivalve splint teach don/doff & wear/care

Bivalve
Distal Radial Fx Tx (usually post-op): Modalities: moist heat, paraffin, may use TENS or fluidotherapy; AROM of all involved joints (intrinsic stretching, tendon gliding, isolate wrist extensors), HEP-active ROM addressing all involved joints, use splint at night to keep wrist neutral if joint is painful or has numbness/tingling, keep elevated if edema persists, if using this type splint teach don/doff & wear/care

Teach don/doff & wear/care
Distal Radial Fx Tx (usually post-op): Modalities: moist heat, paraffin, may use TENS or fluidotherapy; AROM of all involved joints (intrinsic stretching, tendon gliding, isolate wrist extensors), HEP-active ROM addressing all involved joints, use splint at night to keep wrist neutral if joint is painful or has numbness/tingling, keep elevated if edema persists, if using bivalve splint do this

Orthopedic surgeon
With Os Acromiale, no PT! Instead refer to this practitioner

Overuse
Impingement Stage I (Edema/Hemmorhage): < 25 years of Age, this Etiology, Reversible, Conservative Treatment

Yes
Impingement Stage I (Edema/Hemmorhage): < 25 years of Age, Overuse Etiology, Reversible?

Conservative
Impingement Stage I (Edema/Hemmorhage): < 25 years of Age, Overuse Etiology, Reversible, this type Treatment

Tendon
Does full thickness RCT tear tendon or muscle?

RCT/impingement
Diff Dx for these: Instability, AC arthritis, Acute bursitis, Calcific Tendonitis, Cancer, GH arthritis, Peripheral nerve injury/ Radiculopathy/Brachial plexus

Instability/cancer
Diff Dx for RCT/impingement: these, AC arthritis, Acute bursitis, Calcific Tendonitis, GH arthritis, Peripheral nerve injury/ Radiculopathy/Brachial plexus

AC/GH
Diff Dx for RCT/impingement: Instability, these types arthritis, Acute bursitis, Calcific Tendonitis, Cancer, Peripheral nerve injury/ Radiculopathy/Brachial plexus

Bursitis
Diff Dx for RCT/impingement: Instability, AC arthritis, Acute this, Calcific Tendonitis, Cancer, GH arthritis, Peripheral nerve injury/ Radiculopathy/Brachial plexus

Calcific
Diff Dx for RCT/impingement: Instability, AC arthritis, Acute bursitis, this type Tendonitis, Cancer, GH arthritis, Peripheral nerve injury/ Radiculopathy/Brachial plexus

Peripheral nerve injury/radiculopathy/brachial plexus
Diff Dx for RCT/impingement: Instability, AC arthritis, Acute bursitis, Calcific Tendonitis, Cancer, GH arthritis, these nerve issues

Supination/pronation
You should test these to differentiate from C5-6 nerve root injury

C5-6
You should test pronation/supination to differentiate from this level nerve root injury

Arthroscopic Acromioplasty
Advantages to this intervention: Improved Cosmesis, Decreased Deltoid Opening, Shortens Hospital Stay, Earlier active motion and more aggressive with a RROM, can have limitations for rotator cuff repair

Cosmesis
Advantages to Arthroscopic Acromioplasty: Improved this, Decreased Deltoid Opening, Shortens Hospital Stay, Earlier active motion and more aggressive with a RROM, can have limitations for rotator cuff repair

Deltoid opening/hospital stay
Advantages to Arthroscopic Acromioplasty: Improved Cosmesis, Decreased this, Shortens this, Earlier active motion and more aggressive with a RROM, can have limitations for rotator cuff repair

Active motion/RROM
Advantages to Arthroscopic Acromioplasty: Improved Cosmesis, Decreased Deltoid Opening, Shortens Hospital Stay, Earlier this and more aggressive with this, can have limitations for rotator cuff repair

RC repair
Advantages to Arthroscopic Acromioplasty: Improved Cosmesis, Decreased Deltoid Opening, Shortens Hospital Stay, Earlier active motion and more aggressive with a RROM, can have limitations for this

No
If you tear both labrum & glenoid capsule, is there any chance they could heal back?

SLAP lesions
In regards to these: Type I (degen tearing but intact biceps), II (detachment from glenoid), III (bucket handle tear), IV (tear extends into biceps tendon); Debride Type I, Repair types II-IV

Degen tearing but intact biceps/detach from glenoid
In regards to SLAP lesions: Type I (this), II (this), III (bucket handle tear), IV (tear extends into biceps tendon); Debride Type I, Repair types II-IV

Bucket handle tear
In regards to SLAP lesions: Type I (degen tearing but intact biceps), II (detachment from glenoid), III (this), IV (tear extends into biceps tendon); Debride Type I, Repair types II-IV

Tear extends into biceps tendon
In regards to SLAP lesions: Type I (degen tearing but intact biceps), II (detachment from glenoid), III (bucket handle tear), IV (this); Debride Type I, Repair types II-IV

Debride
In regards to SLAP lesions: Type I (degen tearing but intact biceps), II (detachment from glenoid), III (bucket handle tear), IV (tear extends into biceps tendon); do this w/Type I, Repair types II-IV

SLAP lesion
UPS worker grabs box they didn’t expect to be so heavy, what shoulder pathology may occur?

No
Does instability typically occur in one plane?

Anterior
Most common shoulder instability: this dislocation (90% of dislocations), Inferior Dislocation, Anterior-Inferior (MDI), Posterior Dislocation (2-4% of all shoulder instabilities); Recurrence rate of dislocation has been documented to range from 60-90% in young active individuals

90
Most common shoulder instability: Anterior Dislocation (this% of dislocations), Inferior Dislocation, Anterior-Inferior (MDI), Posterior Dislocation (2-4% of all shoulder instabilities); Recurrence rate of dislocation has been documented to range from 60-90% in young active individuals

MDI/2-4
Most common shoulder instability: Anterior Dislocation (90% of dislocations), Inferior Dislocation, Anterior-Inferior (this), Posterior Dislocation (this% of all shoulder instabilities); Recurrence rate of dislocation has been documented to range from 60-90% in young active individuals

Recurrence
Most common shoulder instability: Anterior Dislocation (90% of dislocations), Inferior Dislocation, Anterior-Inferior (MDI), Posterior Dislocation (2-4% of all shoulder instabilities); this rate of dislocation has been documented to range from 60-90% in young active individuals

60-90
Most common shoulder instability: Anterior Dislocation (90% of dislocations), Inferior Dislocation, Anterior-Inferior (MDI), Posterior Dislocation (2-4% of all shoulder instabilities); Recurrence rate of dislocation has been documented to range from this% in young active individuals

Young/active
Most common shoulder instability: Anterior Dislocation (90% of dislocations), Inferior Dislocation, Anterior-Inferior (MDI), Posterior Dislocation (2-4% of all shoulder instabilities); Recurrence rate of dislocation has been documented to range from 60-90% in this population

CTS
This S/S: Pain/paresthesia, usually worse at night; Weakness (dropping things); In advanced cases, atrophy of thenar area secondary to recurrent motor branch of median nerve involvement; Sometimes, edema and/or radiating pain

Carpal Tunnel Syndrome
CTS

Night
CTS S/S: Pain/paresthesia, usually worse at this time; Weakness (dropping things); In advanced cases, atrophy of thenar area secondary to recurrent motor branch of median nerve involvement; Sometimes, edema and/or radiating pain

Drops things/thenar area atrophy
CTS S/S: Pain/paresthesia, usually worse at night; Weakness (pt does this); In advanced cases, this secondary to recurrent motor branch of median nerve involvement; Sometimes, edema and/or radiating pain

Recurrent motor branch of median n
CTS S/S: Pain/paresthesia, usually worse at night; Weakness (dropping things); In advanced cases, atrophy of thenar area secondary to involvement of this; Sometimes, edema and/or radiating pain

Edema/radiating pain
CTS S/S: Pain/paresthesia, usually worse at night; Weakness (dropping things); In advanced cases, atrophy of thenar area secondary to recurrent motor branch of median nerve involvement; Sometimes, these may occur

Dislocation
With this, joint surface are no longer in contact & joint requires reduction to re-associate articular surfaces (voluntary & non); With subluxation, joint does not frankly dislocate, slips or translates greater than normal, joint surfaces may lose contact however they self reduce (voluntary & non)

Reduction
With dislocation, joint surface are no longer in contact & joint requires this to re-associate articular surfaces (voluntary & non); With subluxation, joint does not frankly dislocate, slips or translates greater than normal, joint surfaces may lose contact however they self reduce (voluntary & non)

Subluxation
With dislocation, joint surface are no longer in contact & joint requires reduction to re-associate articular surfaces (voluntary & non); With this, joint does not frankly dislocate, slips or translates greater than normal, joint surfaces may lose contact however they self reduce (voluntary & non)

Frankly dislocate
With dislocation, joint surface are no longer in contact & joint requires reduction to re-associate articular surfaces (voluntary & non); With subluxation, joint does not do this, slips or translates greater than normal, joint surfaces may lose contact however they self reduce (voluntary & non)

Slips/translates
With dislocation, joint surface are no longer in contact & joint requires reduction to re-associate articular surfaces (voluntary & non); With subluxation, joint does not frankly dislocate, does one of these greater than normal, joint surfaces may lose contact however they self reduce (voluntary & non)

Self reduce
With dislocation, joint surface are no longer in contact & joint requires reduction to re-associate articular surfaces (voluntary & non); With subluxation, joint does not frankly dislocate, slips or translates greater than normal, joint surfaces may lose contact however they do this (voluntary & non)

CTS
Objective findings w/this may include: Phalen’s (changes in paresthesia with wrist flexion for 60 secs) or Reverse Phalen’s (changes with wrist extension)

Phalens
Objective findings w/CTS may include: this (changes in paresthesia with wrist flexion for 60 secs) or Reverse this (changes with wrist extension)

Paresthesia
Objective findings w/CTS may include: Phalen’s (changes in this with wrist flexion for 60 secs) or Reverse Phalen’s (changes with wrist extension)

60 secs
Objective findings w/CTS may include: Phalen’s (changes in paresthesia with wrist flexion for this long) or Reverse Phalen’s (changes with wrist extension)

Hill-Sachs
This Lesion is defect on posterior aspect of HH; Reverse this is defect on anterior aspect of HH

HH
Hill-Sachs Lesion is defect on posterior aspect of this; Reverse Hill-Sachs is defect on anterior aspect of this

Frozen shoulder
Stage III this (stiffness much more pronounced & surrounding muscles have become atrophic, pain is reducing); Stage II & III = 8 months; Stage IV (resolution, ROM gradually returns in majority of pts, however many never regain full ROM, pain nearly absent)

Stiffness/pronounced
Stage III frozen shoulder (this much more this & surrounding muscles have become atrophic, pain is reducing); Stage II & III = 8 months; Stage IV (resolution, ROM gradually returns in majority of pts, however many never regain full ROM, pain nearly absent)

Atrophic
Stage III frozen shoulder (stiffness much more pronounced & surrounding muscles have become this, pain is reducing); Stage II & III = 8 months; Stage IV (resolution, ROM gradually returns in majority of pts, however many never regain full ROM, pain nearly absent)

Reducing
Stage III frozen shoulder (stiffness much more pronounced & surrounding muscles have become atrophic, pain is this); Stage II & III = 8 months; Stage IV (resolution, ROM gradually returns in majority of pts, however many never regain full ROM, pain nearly absent)

Pain
Stage III frozen shoulder (stiffness much more pronounced & surrounding muscles have become atrophic, this is reducing); Stage II & III = 8 months; Stage IV (resolution, ROM gradually returns in majority of pts, however many never regain full ROM, this nearly absent)

II/III
Stage III frozen shoulder (stiffness much more pronounced & surrounding muscles have become atrophic, pain is reducing); these stages = 8 months; Stage IV (resolution, ROM gradually returns in majority of pts, however many never regain full ROM, pain nearly absent)

8 months
Stage III frozen shoulder (stiffness much more pronounced & surrounding muscles have become atrophic, pain is reducing); Stage II & III = this long; Stage IV (resolution, ROM gradually returns in majority of pts, however many never regain full ROM, pain nearly absent)

ROM
Stage III frozen shoulder (stiffness much more pronounced & surrounding muscles have become atrophic, pain is reducing); Stage II & III = 8 months; Stage IV (resolution, this gradually returns in majority of pts, however many never regain full this, pain nearly absent)

Passive forceful flexion
Don’t do this on a mallet finger or boutonniere-tendons are thin and fragile

Mallet finger/boutonniere
Don’t do passive forceful flexion on either of these conditions-tendons are thin and fragile

Thin/fragile
Don’t do passive forceful flexion on a mallet finger or boutonniere-tendons are this

Swan Neck Deformity
This is HE of PIP & flexion of DIP; Complicated mechanics of extensor tendons (PIP joint synovitis causes laxity of PIP volar plate which produces PIP HE); Imbalance of intrinsics worsens condition; Common in RA pt’s

PIP HE/DIP flexion
Swan Neck Deformity is this; Complicated mechanics of extensor tendons (PIP joint synovitis causes laxity of PIP volar plate which produces PIP HE); Imbalance of intrinsics worsens condition; Common in RA pt’s

Extensor/PIP synovitis
Swan Neck Deformity is HE of PIP & flexion of DIP; Complicated mechanics of these tendons (this causes laxity of PIP volar plate which produces PIP HE); Imbalance of intrinsics worsens condition; Common in Rheumatoid Arthritis patients

PIP volar plate laxity/imbalance of intrinsics
Swan Neck Deformity is HE of PIP & flexion of DIP; Complicated mechanics of extensor tendons (PIP joint synovitis causes this which produces PIP HE); this worsens condition; Common in RA pt’s

RA
Swan Neck Deformity is HE of PIP & flexion of DIP; Complicated mechanics of extensor tendons (PIP joint synovitis causes laxity of PIP volar plate which produces PIP HE); Imbalance of intrinsics worsens condition; Common in these pt’s

DeQuervains Tenosynovitis
This condition Mgmt (Non-operative): Splint limiting wrist and thumb ROM, Stretching, ASTYM; Outcome studies show 80% success rate with average of 8 visits

Wrist/thumb
DeQuervain’s Tenosynovitis Mgmt (Non-operative): Splint limiting these ROM, Stretching, ASTYM; Outcome studies show 80% success rate with average of 8 visits

Stretching/ASTYM
DeQuervain’s Tenosynovitis Mgmt (Non-operative): Splint limiting wrist and thumb ROM, these; Outcome studies show 80% success rate with average of 8 visits

80
DeQuervain’s Tenosynovitis Mgmt (Non-operative): Splint limiting wrist and thumb ROM, Stretching, ASTYM; Outcome studies show this% success rate with average of 8 visits

8
DeQuervain’s Tenosynovitis Mgmt (Non-operative): Splint limiting wrist and thumb ROM, Stretching, ASTYM; Outcome studies show 80% success rate with average of this many visits

Little Leaguers Elbow
This condition S/S: Medial elbow pain/tenderness, possible increase in valgus, decreased elbow ext, inability to throw due to pain, radiographic exam shows separation or fragmentation of medial epicondylar epiphysis

Medial
Little Leaguer’s Elbow S/S: this elbow pain/tenderness, possible increase in valgus, decreased elbow ext, inability to throw due to pain, radiographic exam shows separation or fragmentation of medial epicondylar epiphysis

Valgus/elbow ext
Little Leaguer’s Elbow S/S: Medial elbow pain/tenderness, possible increase in this, decreased this, inability to throw due to pain, radiographic exam shows separation or fragmentation of medial epicondylar epiphysis

Radiographic
Little Leaguer’s Elbow S/S: Medial elbow pain/tenderness, possible increase in valgus, decreased elbow ext, inability to throw due to pain, this type exam shows separation or fragmentation of medial epicondylar epiphysis

Separation/fragmenting of med epicondyle epiphysis
Little Leaguer’s Elbow S/S: Medial elbow pain/tenderness, possible increase in valgus, decreased elbow ext, inability to throw due to pain, radiographic exam shows one of these

Lateral epicondylitis
This condition risk factors: F>M, occasionally bilateral, insidious onset, rarely traumatic, mainly overuse (repetitive use – painters/bricklayers/factory workers; sport – poor technique/equipment); age 35-55 most common; common to have Hx of upper limb/cervical dysfunction

F
Lateral Epicondylitis risk factors: F or M more? occasionally bilateral, insidious onset, rarely traumatic, mainly overuse (repetitive use – painters/bricklayers/factory workers; sport – poor technique/equipment); age 35-55 most common; common to have Hx of upper limb/cervical dysfunction

Insidious/trauma
Lateral Epicondylitis risk factors: F>M, occasionally bilateral, this onset, rarely this, mainly overuse (repetitive use – painters/bricklayers/factory workers; sport – poor technique/equipment); age 35-55 most common; common to have Hx of upper limb/cervical dysfunction

Poor technique/equipment
Lateral Epicondylitis risk factors: F>M, occasionally bilateral, insidious onset, rarely traumatic, mainly overuse (repetitive use – painters/bricklayers/factory workers; sport – these causes); age 35-55 most common; common to have Hx of upper limb/cervical dysfunction

35-55
Lateral Epicondylitis risk factors: F>M, occasionally bilateral, insidious onset, rarely traumatic, mainly overuse (repetitive use – painters/bricklayers/factory workers; sport – poor technique/equipment); these ages most common; common to have Hx of upper limb/cervical dysfunction

Upper limb/cervical dysfunction
Lateral Epicondylitis risk factors: F>M, occasionally bilateral, insidious onset, rarely traumatic, mainly overuse (repetitive use – painters/bricklayers/factory workers; sport – poor technique/equipment); age 35-55 most common; common to have Hx of this

Post/inf
With primary impingement, mobilize these capsules; address soft tissues that promote aberrant mechanics (all mm that attach to scap & promote downward rotation/protraction of GH joint – upper traps/lev scap/rhomboids/pec minor)

Downward rotation/protraction
With primary impingement, mobilize post/inf capsules; address soft tissues that promote aberrant mechanics (all mm that attach to scap & promote these of GH joint – upper traps/lev scap/rhomboids/pec minor)

GH
With primary impingement, mobilize post/inf capsules; address soft tissues that promote aberrant mechanics (all mm that attach to scap & promote downward rotation/protraction of this joint – upper traps/lev scap/rhomboids/pec minor)

Upper traps/lev scap/rhomboids/pec minor
With primary impingement, mobilize post/inf capsules; address soft tissues that promote aberrant mechanics (all mm that attach to scap & promote downward rotation/protraction of GH joint – these mm)

Flexion/valgus
Elbow position in predisposed to flexion & valgus these positions due to: oblique trochlea, shaft of humerus anteverted, & axis of rotation not straight line btwn 2 condyles

Trochlea
Elbow position in predisposed to flexion & valgus due to: oblique this, shaft of humerus anteverted, & axis of rotation not straight line btwn 2 condyles

Anteverted
Elbow position in predisposed to flexion & valgus due to: oblique trochlea, shaft of humerus is this, & axis of rotation not straight line btwn 2 condyles

Condyles
Elbow position in predisposed to flexion & valgus due to: oblique trochlea, shaft of humerus anteverted, & axis of rotation not straight line btwn these

Full flex
In this position, posterior portion of UCL (MCL) gives more stability than anterior portion

Posterior
In full flexion, this portion of UCL (MCL) gives more stability

ECRB
This muscle stabilized wrist when extended

Radial nerve palsy
Mid shaft humeral Fx may cause this nerve condition

4-6 weeks
With CTS Tx, progress to grip/wrist strengthening at this time post surgery

Dorsal/volar radioulnar/UCL/ulnolunate origin/ulnotriquetral
TFCC is made up of these ligs, central articular disc, meniscus homolog, & ECU subsheath

Central articular
TFCC is made up of dorsal/volar radioulnar ligs, this disc, meniscus homolog, ulnar collateral lig, ECU subsheath, & origin of ulnolunate/ulnotriquetral ligs

Meniscus
TFCC is made up of dorsal/volar radioulnar ligs, central articular disc, this homolog, ulnar collateral lig, ECU subsheath, & origin of ulnolunate/ulnotriquetral ligs

ECU
TFCC is made up of dorsal/volar radioulnar ligs, central articular disc, meniscus homolog, ulnar collateral lig, this subsheath, & origin of ulnolunate/ulnotriquetral ligs

Traumatic
TFCC Injuries: Type 1 (this type; FOOSH-forearm pronated/wrist ext; traction injury to ulnar aspect of wrist) or Type 2 (degenerative; ulno-carpal impaction; more ulnar variance); DRUJ dislocation is commonly associated

Traction
TFCC Injuries: Type 1 (traumatic; FOOSH-forearm pronated/wrist ext; this type injury to ulnar aspect of wrist) or Type 2 (degenerative; ulno-carpal impaction; more ulnar variance); DRUJ dislocation is commonly associated

Degenerative/ulno-carpal
TFCC Injuries: Type 1 (traumatic; FOOSH-forearm pronated/wrist ext; traction injury to ulnar aspect of wrist) or Type 2 (this type; this type impaction; more ulnar variance); DRUJ dislocation is commonly associated

Ulnar variance/DRUJ
TFCC Injuries: Type 1 (traumatic; FOOSH-forearm pronated/wrist ext; traction injury to ulnar aspect of wrist) or Type 2 (degenerative; ulno-carpal impaction; more this); this dislocation is commonly associated

TFCC
This area injuries S/S: ulnar wrist pain, often diffuse wrist pain, pain w/activities requiring deviation or rotation (turning key/opening door/lifting/pouring gallon of milk), crepitus, + fovea sign, pt often describes instability or “catching”, + this compression

Diffuse
TFCC injuries S/S: ulnar wrist pain, often this type wrist pain, pain w/activities requiring deviation or rotation (turning key/opening door/lifting/pouring gallon of milk), crepitus, + fovea sign, pt often describes instability or “catching”, + TFCC compression

Deviation/rotation
TFCC injuries S/S: ulnar wrist pain, often diffuse wrist pain, pain w/activities requiring one of these mvmts, crepitus, + fovea sign, pt often describes instability or “catching”, + TFCC compression

Crepitus/fovea
TFCC injuries S/S: ulnar wrist pain, often diffuse wrist pain, pain w/activities requiring deviation or rotation (turning key/opening door/lifting/pouring gallon of milk), this joint feel, + this sign, pt often describes instability or “catching”, + TFCC compression

Catching/compression
TFCC injuries S/S: ulnar wrist pain, often diffuse wrist pain, pain w/activities requiring deviation or rotation (turning key/opening door/lifting/pouring gallon of milk), crepitus, + fovea sign, pt often describes instability or “this”, + this of TFCC

TFCC
This surgery: arthroscopic debridement &/or repair (75-90% good to excellent results; almost all pt’s able to RTW); ulnar shortening/limited ulnar head resection/darrach procedure

Arthroscopic debridement/75-90
TFCC surgery: this &/or repair (this% good to excellent results; almost all pt’s able to RTW); ulnar shortening/limited ulnar head resection/darrach procedure

RTW
TFCC surgery: arthroscopic debridement &/or repair (75-90% good to excellent results; almost all pt’s able to this); ulnar shortening/limited ulnar head resection/darrach procedure

Ulnar shortening/limited ulnar head resection/darrach
TFCC surgery: arthroscopic debridement &/or repair (75-90% good to excellent results; almost all pt’s able to RTW); these procedures

Debridement/0-2 wks
TFCC post-op rehab: this @this time, AROM progress as tolerated, Wrist splint, 2 weeks p/o: All fxnal activity allowed if painfree, Progress PRE’s/strengthening – begin grip strength in supination & progress to neutral then pronation; Repair/Casted for 6-8 weeks (begin AROM & progress as tolerated; Protective splint; Progress grip/UE strength as above; 3-4 months-Fxnal activity allowed & possible RTW); Ulnar shortening & Darrach procedure in general require 6-8 weeks of immobilization & slow progression of ROM & strengthening, RT previous activities after at least 4 months

AROM
TFCC post-op rehab: Debridement @0-2 weeks, this progress as tolerated, Wrist splint, 2 weeks p/o: All fxnal activity allowed if painfree, Progress PRE’s/strengthening – begin grip strength in supination & progress to neutral then pronation; Repair/Casted for 6-8 weeks (begin AROM & progress as tolerated; Protective splint; Progress grip/UE strength as above; 3-4 months-Fxnal activity allowed & possible RTW); Ulnar shortening & Darrach procedure in general require 6-8 weeks of immobilization & slow progression of ROM & strength, RT previous activities after at least 4 months

Painfree
TFCC post-op rehab: Debridement @0-2 weeks, AROM progress as tolerated, Wrist splint, 2 weeks p/o: All fxnal activity allowed if this, Progress PRE’s/strengthening – begin grip strength in supination & progress to neutral then pronation; Repair/Casted for 6-8 weeks (begin AROM & progress as tolerated; Protective splint; Progress grip/UE strength as above; 3-4 months-Fxnal activity allowed & possible RTW); Ulnar shortening & Darrach procedure in general require 6-8 weeks of immobilization & slow progression of ROM & strength, RT previous activities after at least 4 months

Supination
TFCC post-op rehab: Debridement @0-2 weeks, AROM progress as tolerated, Wrist splint, 2 weeks p/o: All fxnal activity allowed if painfree, Progress PRE’s/strengthening – begin grip strength in this position & progress; Repair/Casted for 6-8 weeks (begin AROM & progress as tolerated; Protective splint; Progress grip/UE strength as above; 3-4 months-Fxnal activity allowed & possible RTW); Ulnar shortening & Darrach procedure in general require 6-8 weeks of immobilization & slow progression of ROM & strengthening, RT previous activities after at least 4 months

6-8 weeks
TFCC post-op rehab: Debridement @0-2 weeks, AROM progress as tolerated, Wrist splint, 2 weeks p/o: All fxnal activity allowed if painfree, Progress PRE’s/strengthening – begin grip strength in supination & progress to neutral then pronation; Repair/Casted for this long (begin AROM & progress as tolerated; Protective splint; Progress grip/UE strength as above; 3-4 months-Fxnal activity allowed & possible RTW); Ulnar shortening & Darrach procedure in general require 6-8 weeks of immobilization & slow progression of ROM & strength, RT previous activities after at least 4 months

3-4 months
TFCC post-op rehab: Debridement @0-2 weeks, AROM progress as tolerated, Wrist splint, 2 weeks p/o: All fxnal activity allowed if painfree, Progress PRE’s/strengthening – begin grip strength in supination & progress to neutral then pronation; Repair/Casted for 6-8 weeks (begin AROM & progress as tolerated; Protective splint; Progress grip/UE strength as above; at this time-Fxnal activity allowed & possible RTW); Ulnar shortening & Darrach procedure in general require 6-8 weeks of immobilization & slow progression of ROM & strength, RT previous activities after at least 4 months

Ulnar shortening
TFCC post-op rehab: Debridement @0-2 weeks, AROM progress as tolerated, Wrist splint, 2 weeks p/o: All fxnal activity allowed if painfree, Progress PRE’s/strengthening – begin grip strength in supination & progress to neutral then pronation; Repair/Casted for 6-8 weeks (begin AROM & progress as tolerated; Protective splint; Progress grip/UE strength as above; 3-4 months-Fxnal activity allowed & possible RTW); this & Darrach procedure in general require 6-8 weeks of immobilization & slow progression of ROM & strengthening, RT previous activities after at least 4 months

6-8 weeks/immobilization
TFCC post-op rehab: Debridement @0-2 weeks, AROM progress as tolerated, Wrist splint, 2 weeks p/o: All fxnal activity allowed if painfree, Progress PRE’s/strengthening – begin grip strength in supination & progress to neutral then pronation; Repair/Casted for 6-8 weeks (begin AROM & progress as tolerated; Protective splint; Progress grip/UE strength as above; 3-4 months-Fxnal activity allowed & possible RTW); Ulnar shortening & Darrach procedure in general require this time of this & slow progression of ROM & strength, RT previous activities after at least 4 months

4 months
TFCC post-op rehab: Debridement @0-2 weeks, AROM progress as tolerated, Wrist splint, 2 weeks p/o: All fxnal activity allowed if painfree, Progress PRE’s/strengthening – begin grip strength in supination & progress to neutral then pronation; Repair/Casted for 6-8 weeks (begin AROM & progress as tolerated; Protective splint; Progress grip/UE strength as above; 3-4 months-Fxnal activity allowed & possible RTW); Ulnar shortening & Darrach procedure in general require 6-8 weeks of immobilization & slow progression of ROM & strength, RT previous activities after at least this long

Immobilize
Acute Tx of flexor tendon, if partial tear then may do this

Dorsal blocking
Flexor Tendon injury objective findings: usually presents w/this type cast, wound, edema, sensory changes secondary to digital nerve involvement common

Sensory
Flexor Tendon injury objective findings: usually presents w/dorsal blocking cast, wound, edema, these changes secondary to digital nerve involvement common

Active ext/passive flex
Flexor Tendon injuries PT mgmt has many protocols: passive flexion, this, early motion needs to be started in 1st week after surgery

1st week
Flexor Tendon injuries PT mgmt has many protocols: passive flexion, active ext/passive flex, early motion needs to be started in this time after surgery

Tendon/scar
One tendon injury goal is to prevent adherence of these

Dorsal block splint
Initial PT Tx for flexor tendon injury: fabricate this w/20-30 wrist flexion & MCP 70-80; attach rubberband traction w/palmar pulley

20-30
Initial PT Tx for flexor tendon injury: fabricate dorsal block splint w/this degs wrist flexion & MCP 70-80; attach rubberband traction w/palmar pulley

Flexion
Initial PT Tx for flexor tendon injury: fabricate dorsal block splint w/20-30 this wrist mvmt & MCP 70-80; attach rubberband traction w/palmar pulley

70-80
Initial PT Tx for flexor tendon injury: fabricate dorsal block splint w/20-30 wrist flexion & MCP this many degs; attach rubberband traction w/palmar pulley

Rubberband traction
Initial PT Tx for flexor tendon injury: fabricate dorsal block splint w/20-30 wrist flexion & MCP 70-80; attach this w/palmar pulley

Palmar pulley
Initial PT Tx for flexor tendon injury: fabricate dorsal block splint w/20-30 wrist flexion & MCP 70-80; attach rubberband traction w/this

MP
Initial PT Tx for flexor tendon injury: DBS full time, start active ext in splint w/these joints blocked, passive flex of all finger joints

All
Initial PT Tx for flexor tendon injury: DBS full time, start active ext in splint w/MP’s blocked, passive flex of these finger joints

Scar massage
PT Tx for flexor tendon injury: at 3 weeks start this, 3-4 weeks start gentle place/hold, 4-5 week start AROM (avoid forceful ext, simultaneous finger/wrist ext, D/C dynamic traction)

Gentle place/hold
PT Tx for flexor tendon injury: at 3 weeks start scar massage, 3-4 weeks start this, 4-5 week start AROM (avoid forceful ext, simultaneous finger/wrist ext, D/C dynamic traction)

Forceful ext
PT Tx for flexor tendon injury: at 3 weeks start scar massage, 3-4 weeks start gentle place/hold, 4-5 week start AROM (avoid this, simultaneous finger/wrist ext, D/C dynamic traction)

Finger/wrist ext
PT Tx for flexor tendon injury: at 3 weeks start scar massage, 3-4 weeks start gentle place/hold, 4-5 week start AROM (avoid forceful ext, simultaneous these, D/C dynamic traction)

Dynamic traction
PT Tx for flexor tendon injury: at 3 weeks start scar massage, 3-4 weeks start gentle place/hold, 4-5 week start AROM (avoid forceful ext, simultaneous finger/wrist ext, D/C this)

Gentle joint blocking/strengthening w/o stress
PT Tx for flexor tendon injury: at 6 weeks start this to repair, at 6-8 weeks D/C splint, at 10 weeks start light grip strengthening; variable but in general at 8-10 weeks start PROM/splinting if flex contracture present; at 12 weeks, no restrictions

Splint/light grip strengthening
PT Tx for flexor tendon injury: at 6 weeks start gentle joint blocking/strengthening w/o stress to repair, at 6-8 weeks D/C this, at 10 weeks start this; variable but in general at 8-10 weeks start PROM/splinting if flex contracture present; at 12 weeks, no restrictions

PROM
PT Tx for flexor tendon injury: at 6 weeks start gentle joint blocking/strengthening w/o stress to repair, at 6-8 weeks D/C splint, at 10 weeks start light grip strengthening; variable but in general at 8-10 weeks start this/splinting if flex contracture present; at 12 weeks, no restrictions

Flex contracture/12 wks
PT Tx for flexor tendon injury: at 6 weeks start gentle joint blocking/strengthening w/o stress to repair, at 6-8 weeks D/C splint, at 10 weeks start light grip strengthening; variable but in general at 8-10 weeks start PROM/splinting if this present; at this time, no restrictions

Tenolysis
With flexor tendon injury, this may be indicated if not adequate ROM & tendon excursion; usually done when scar softens, around 4-6 months post injury; need good PROM for successful this

Not adequate ROM/tendon excursion
With flexor tendon injury, tenolysis may be indicated if this; usually done when scar softens, around 4-6 months post injury; need good PROM for successful tenolysis

4-6 months/PROM
With flexor tendon injury, tenolysis may be indicated if not adequate ROM & tendon excursion; usually done when scar softens, around this long post injury; need good this for successful tenolysis

Mallet finger/boutonniere/swan neck deformity
These are the most major/common extensor tendon lacerations

Mallet finger
This is rupture/laceration of terminal tendon; PT mgmt: splint 6-8 weeks, gradually decrease use of splint & watch for extensor lag

Rupture/laceration of terminal tendon
Mallet finger is this; PT mgmt: splint 6-8 weeks, gradually decrease use of splint & watch for extensor lag

Splint
Mallet finger is rupture/laceration of terminal tendon; PT mgmt: do this 6-8 weeks, gradually decrease use of this & watch for extensor lag

6-8 weeks
Mallet finger is rupture/laceration of terminal tendon; PT mgmt: splint this long, gradually decrease use of splint & watch for extensor lag

Extensor lag
Mallet finger is rupture/laceration of terminal tendon; PT mgmt: splint 6-8 weeks, gradually decrease use of splint & watch for this

EPB/APL
1st dorsal compartment of hand contains these muscles

DeQuervains Tenosynovitis
Tight cast/poorly fitting splint can cause this hand condition

Trigger finger
With this condition, use PIP/MP splint

PIP/MP
With trigger finger, use splint for these joints

Dislocation
This elbow condition can start AROM 1 wk into Tx

AROM
Elbow dislocation can start this ROM 1 wk into Tx

1 week
Elbow dislocation can start AROM this time into Tx

Mallet finger
This finger condition is similar to Fx and should be treated as such

Fx
Mallet finger is similar to this type condition and should be treated as such

Overhead
This type activity of grades 1-2 AC separation should NOT be limited for 6-8 wks

1-2
Overhead activity of these grades AC separation should NOT be limited for 6-8 wks

AC
Overhead activity of grades 1-2 this joint separation should NOT be limited for 6-8 wks

GH
This dislocation can start RC strengthening in 1-3 wks

RC strengthening
GH dislocation can start this Tx in 1-3 wks

1-3 wks
GH dislocation can start RC strengthening in this time

Elderly females
Colles Fx is most common in this population

Colles
This Fx is most common in elderly females

Shoulder dislocation
This condition may lead to Bankart lesion

Bankart lesion
Shoulder dislocation may lead to this

Ext/add
Normal shoulder ROM: Flex/Abd: 180, these: 50, ER: 90, IR: 70-90, Ratio of GH to Scapula movement: 2/3 : 1/3

50/ER
Normal shoulder ROM: Flex/Abd: 180, Ext/Add: this, this: 90, IR: 70-90, Ratio of GH to Scapula movement: 2/3 : 1/3

90/IR
Normal shoulder ROM: Flex/Abd: 180, Ext/Add: 50, ER: this, this: 70-90, Ratio of GH to Scapula mvmt: 2/3 : 1/3

70-90/GH to Scapula mvmt
Normal shoulder ROM: Flex/Abd: 180, Ext/Add: 50, ER: 90, IR: this, Ratio of this: 2/3 : 1/3

2/3:1/3
Normal shoulder ROM: Flex/Abd: 180, Ext/Add: 50, ER: 90, IR: 70-90, Ratio of GH to Scapula movement: this

ER/drop
This mvmt (This Sign: Best Test); Tests: supraspinatus, infraspinatus; pt abd arm to 90, elbow flex 90, max ER arm, pt asked to hold, if arm drops into IR = test is positive for tears in infraspinatus and supraspinatus

Supra/infraspinatus
ER (Drop Sign: Best Test); Tests: these mm; pt abd arm to 90, elbow flex 90, max ER arm, pt asked to hold, if arm drops into IR = test is positive for tears in these mm

Abd 90/flex elbow 90/max ER
ER (Drop Sign: Best Test); Tests: supraspinatus, infraspinatus; pt does these, pt asked to hold, if arm drops into IR = test is positive for tears in infraspinatus and supraspinatus

Arm drops into IR
ER (Drop Sign: Best Test); Tests: supraspinatus, infraspinatus; pt abd arm to 90, elbow flex 90, max ER arm, pt asked to hold, if this occurs = test is positive for tears in infraspinatus and supraspinatus

Neer/impingement
This Sign (this type test): passively elevate shoulder in scap plane/IR arm; causes greater tuberosity to jam against anteroinferior border of acromion; Positive sign= pt has pain when arm elevated; Sen: 93%, Spec: 25%, Reliability: 98%

Passively lift shoulder in scap plane/IR arm
Neer Sign (Impingement): do these; causes greater tuberosity to jam against anteroinferior border of acromion; Positive sign= pt has pain when arm elevated; Sen: 93%, Spec: 25%, Reliability: 98%

Greater tub/jam against anteroinferior border of acromion
Neer Sign (Impingement): passively elevate shoulder in scap plane/IR arm; causes this to do this; Positive sign= pt has pain when arm elevated; Sen: 93%, Spec: 25%, Reliability: 98%

Pt has pain when arm elevated/93
Neer Sign (Impingement): passively elevate shoulder in scap plane/IR arm; causes greater tuberosity to jam against anteroinferior border of acromion; Positive sign= this; Sen: this%, Spec: 25%, Reliability: 98%

25/98
Neer Sign (Impingement): passively elevate shoulder in scap plane/IR arm; causes greater tuberosity to jam against anteroinferior border of acromion; Positive sign= pt has pain when arm elevated; Sen: 93%, Spec: this%, Reliability: this%

Frozen shoulder
This: intense Pain (greater at night); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (6 months); Stage II: limited PROM/AROM, pain in all planes of mvmt, end feels become empty, accessory motions become restricted, MMT still remains painless, hitching shoulder noticed w/abd/flex of shoulder

Night
Frozen shoulder: intense Pain (greater at this time); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (6 months); Stage II: limited PROM/AROM, pain in all planes of mvmt, end feels become empty, accessory motions become restricted, MMT still remains painless, hitching of shoulder noticed with abd and flex of shoulder

IR/posture
Frozen shoulder: intense Pain (greater at night); pain inc w/motion (elevation, this); poor this; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (6 months); Stage II: limited PROM/AROM, pain in all planes of mvmt, end feels become empty, accessory motions become restricted, MMT still remains painless, hitching of shoulder noticed with abd and flex of shoulder

9-24 months
Frozen shoulder: intense Pain (greater at night); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts this long; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (6 months); Stage II: limited PROM/AROM, pain in all planes of mvmt, end feels become empty, accessory motions become restricted, MMT still remains painless, hitching of shoulder noticed with abd and flex of shoulder

Plateaus/7-15
Frozen shoulder: intense Pain (greater at night); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then does this; this% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (6 months); Stage II: limited PROM/AROM, pain in all planes of mvmt, end feels become empty, accessory motions become restricted, MMT still remains painless, hitching of shoulder noticed with abd and flex of shoulder

Pain
Frozen shoulder: intense Pain (greater at night); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: this is major complaint, worsens w/mvmts (6 months); Stage II: limited PROM/AROM, pain in all planes of mvmt, end feels become empty, accessory motions become restricted, MMT still remains painless, hitching of shoulder noticed with abd and flex of shoulder

6 months
Frozen shoulder: intense Pain (greater at night); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (lasts this long); Stage II: limited PROM/AROM, pain in all planes of mvmt, end feels become empty, accessory motions become restricted, MMT still remains painless, hitching of shoulder noticed with abd and flex of shoulder

PROM/AROM
Frozen shoulder: intense Pain (greater at night); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (6 months); Stage II: limited these, pain in all planes of mvmt, end feels become empty, accessory motions become restricted, MMT still remains painless, hitching of shoulder noticed with abd and flex of shoulder

All/end feels
Frozen shoulder: intense Pain (greater at night); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (6 months); Stage II: limited PROM/AROM, pain in these planes of mvmt, these become empty, accessory motions become restricted, MMT still remains painless, hitching of shoulder noticed with abd and flex of shoulder

Empty/accessory motions
Frozen shoulder: intense Pain (greater at night); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (6 months); Stage II: limited PROM/AROM, pain in all planes of mvmt, end feels become this, these become restricted, MMT still remains painless, hitching of shoulder noticed with abd and flex of shoulder

Restricted/MMT
Frozen shoulder: intense Pain (greater at night); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (6 months); Stage II: limited PROM/AROM, pain in all planes of mvmt, end feels become empty, accessory motions become this, this still remains painless, hitching of shoulder noticed with abd and flex of shoulder

Painless/hitching
Frozen shoulder: intense Pain (greater at night); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (6 months); Stage II: limited PROM/AROM, pain in all planes of mvmt, end feels become empty, accessory motions become restricted, MMT still remains this, this of shoulder noticed with abd and flex of shoulder

Abd/flex
Frozen shoulder: intense Pain (greater at night); pain inc w/motion (elevation, IR); poor posture; holds arm in dependent position; lasts 9-24 months; caught early = more favorable outcome; progress is best initially, then plateaus; 7-15% lose full ROM; Stage I: pain is major complaint, worsens w/mvmts (6 months); Stage II: limited PROM/AROM, pain in all planes of mvmt, end feels become empty, accessory motions become restricted, MMT still painless, hitching of shoulder noticed w/these

Hawkins/flex arm 90 degs
This test (Impingement): tests CA lig; do this then IR shoulder, pushes supraspinatus against ant surface of coracoacromial lig/coracoid process; Positive sign= pain; Sen: 92%, Spec: 25%

IR shoulder/supraspinatus
Hawkins test (Impingement): tests CA lig; frwd flex arm 90° then do this, pushes this against ant surface of coracoacromial lig/coracoid process; Positive sign= pain; Sen: 92%, Spec: 25%

Anterior
Hawkins test (Impingement): tests CA lig; frwd flex arm 90° then IR shoulder, pushes supraspinatus against this surface of coracoacromial lig/coracoid process; Positive sign= pain; Sen: 92%, Spec: 25%

CA
Hawkins test (Impingement): tests this lig; frwd flex arm 90° then IR shoulder, pushes supraspinatus against ant surface of this lig/coracoid process; Positive sign= pain; Sen: 92%, Spec: 25%

Coracoid process/pain
Hawkins test (Impingement): tests CA lig; frwd flex arm 90° then IR shoulder, pushes supraspinatus against ant surface of coracoacromial lig/this; Positive sign= this; Sen: 92%, Spec: 25%

92/25
Hawkins test (Impingement): tests CA lig; frwd flex arm 90° then IR shoulder, pushes supraspinatus against ant surface of coracoacromial lig/coracoid process; Positive sign= pain; Sen: this%, Spec: this%

Forced cross arm adduction/AC joint
This (Impingement): tests this; Pt reaches hand across to opposite shoulder; Examiner: flex arm 90°, horizontally add arm as far as possible; Positive = pain over AC joint; Sen: 82%, Spec: 28%

Flex arm 90 degs/as far as possible
Forced Cross Arm adduction (Impingement): tests AC joint; Pt reaches hand across to opposite shoulder; Examiner: do this, horizontally add arm to this; Positive = pain over AC joint; Sen: 82%, Spec: 28%

82/28
Forced Cross Arm adduction (Impingement): tests AC joint; Pt reaches hand across to opposite shoulder; Examiner: flex arm 90°, horizontally add arm as far as possible; Positive = pain over AC joint; Sen: this%, Spec: this%

Painful arc
This test (Impingement): no pain at beginning of motion, then have pain, then no pain again at end range of motion; Sen: 82%, Spec: 81%

82/81
Painful Arc (Impingement): no pain at beginning of motion, then have pain, then no pain again at end range of motion; Sen: this%, Spec: this%

Speeds
This Test: checks for SLAP Tear, Labral pathology, & Biceps tendon; resist shoulder flex while arm is supinated, then pronated; Positive = inc tenderness in bicipital groove

SLAP tear/labral pathology/biceps tendon
Speed’s Test: checks for these; resist shoulder flex while arm is supinated, then pronated; Positive = inc tenderness in bicipital groove

Resist shoulder flex
Speed’s Test: checks for SLAP Tear, Labral pathology, & Biceps tendon; do this while arm is supinated, then pronated; Positive = inc tenderness in bicipital groove

Supinated/pronated
Speed’s Test: checks for SLAP Tear, Labral pathology, & Biceps tendon; resist shoulder flex while arm is this, then this; Positive = inc tenderness in bicipital groove

Inc tenderness in bicipital groove
Speed’s Test: checks for SLAP Tear, Labral pathology, & Biceps tendon; resist shoulder flex while arm is supinated, then pronated; Positive = this

Apprehension sign
This: checks ant dislocation/instability; abd arm 90/ER shoulder slowly; Positive = pt comes up off table bc they are alarmed & feel like if move more shoulder will dislocate (Apprehension > Pain);Sen: 57%,Spec: 100%

Ant dislocation/instability
Apprehension Sign: checks these; abd arm 90/ER shoulder slowly; Positive = pt comes up off table bc they are alarmed & feel like if move more shoulder will dislocate (Apprehension > Pain);Sen: 57%,Spec: 100%

Abd arm 90/ER slowly
Apprehension Sign: checks ant dislocation/instability; do these; Positive = pt comes up off table bc they are alarmed & feel like if move more shoulder will dislocate (Apprehension > Pain);Sen: 57%,Spec: 100%

57/100
Apprehension Sign: checks ant dislocation/instability; abd arm 90/ER shoulder slowly; Positive = pt comes up off table bc they are alarmed & feel like if move more shoulder will dislocate (Apprehension >Pain);Sen:this%,Spec:this%

Clavicle/upwards
w/AC joint sprain, this would not move this direction

130
HH is inclined approx this many degs from long axis of shaft (known as angle of inclination)

40-50/longitudinal
Clavicle normally can rotate this many degs across this axis

90-120
@this many degs of humeral elevation, the coracoid creates tension on the coracoclavicular ligs as it moves inferolaterally w/respect to clavicle

30/15-30
Clavicle normally has this many degs elevation, this many degs protraction/retraction

SC joint
This is the only true skeletal articulation btwn the axial region & appendicular upper limb

50/30/25
Scapular kinematics: this degs upward rotation, this degs post tilt, this degs ER/IR

Lower trap/serratus ant
These mm are the primary components of upward rotation/scap stabilization in the abducted shoulder near 90 degs or more of elevation

15
Significant positive change for DASH would be a decrease of this many points

8
Significant positive change for Quick DASH would be a decrease of this many points

1.1
Significant change for Numeric Pain Rating Scale (VAS from 1-10) would be the many points

Post tilt/ER
Age related posture changes include inc kyphosis & dec these of scapula

Scap Inf medial border prominence/Coracoid pain/dysKinesia of mvmt
SICK

7-8 mm
More than this distance btwn bottom of acromion & top of HH would indicate subluxation/dislocation

D
A PT recommends a pt Dx w/lateral epicondylitis use a forearm strap while performing activities that exacerbate Sx, use of strap PRIMARILY fxns to: A) inc recruitment of damaged muscle fibers during activity, B) apply pressure to reduce perception of pain during activity, C) limit amt of muscle force generated during activity, D) transfer forces to less affected areas of musculature during activity

C
Which muscle does NOT act to extend the shoulder? A) lat dorsi, B) pec major, C) ant deltoid, D) teres major

B
What structure on the scapula does the humeral head most approximate during abduction? A) clavicle, B) acromion process, C) suprascapular notch, D) coracoid process

D
You’re seeing a female pt w/adhesive capsulitis of the shoulder; given the capsular pattern of the shoulder, what fxnal limitation would they MOST likely have difficulty with? A) reaching across her body, B) reaching into her back hip pocket, C) performing a push-up, D) combing her hair

C
What surgery would MOST likely require a sling w/abduction pillow post-op? A) biceps tendon repair, B) olecranon Fx, C) rotator cuff repair, D) subacromial decompression

C
Your pt informs you her shoulder is very sore after her last Tx; she is a 44yo F w/frozen shoulder; during the previous Tx, you performed grade III-IV mobs followed by progressive resistive exercises; what is the MOST appropriate action for the current Tx session? A) active stretching & resistive ex’s using elastic tubing, B) PROM & superficial heat, C) grade I-II mobs & palliative modalities, D) PNF UE diagonals & cryotherapy

F
T or F: The primary restriction assoc w/adhesive capsulitis is glenohumeral abduction

ER
The primary restriction assoc w/adhesive capsulitis is glenohumeral this

D
You’re working w/a 71yo F status post-rTSA; what’s the MOST likely reason she had this procedure as opposed to a TSA? A) humerus Fx, B) glenohumeral OA, C) significant deltoid weakness, D) irreparable supraspinatus tear

C
You treat a pt w/several injuries impacting the UE including mallet finger & note the affected finger is immobilized in a static splint; what position of the finger would be MOST essential when splinting? A) 5 deg flex at DIP, B) 5 deg flex at PIP, C) 5 deg hyperextension at DIP, D) 5 deg hyperextension at PIP

6-8 wks
Splinting may be required to treat mallet finger for this long

A
A 17yo pt is referred to PT after having shoulder Sx as result of recurrent ant glenohumeral dislocations; the Sx report states a Hill-Sachs Fx was identified; what bony structure is typically involved in this type Fx? A) post sup HH, B) ant medial HH, C) inf glenoid rim, D) humeral greater tuberosity

D
A 32yo tennis player is referred to PT after being Dx w/median n entrapment; the pt’s chief complaints include paresthesias in the hand & progressive weakness; what muscle would most likely contribute to the entrapment? A) abductor pollicis longus, B) flexor digiti minimi, C) flexor digitorum profundus, D) pronator teres

Pronator teres
The median n arises from the cubital fossa & passes btwn the 2 head of this muscle; as a result, can be a possible source of median n entrapment

C
You assess DTRs of a pt as part of a lower quarter screening exam; you determine R & L patellar reflex & L Achilles reflex are 2+ while R Achilles reflex is absent; the condition that could best explain this is: A) cerebral palsy, B) multiple sclerosis, C) peripheral neuropathy, D) intermittent claudication

Motor/sensory/autonomic
Peripheral neuropathy is a broad term that describes a lesion to a peripheral n; pt’s may exhibit these type changes

Inc sensitivity to touch/sensation loss/muscle weakness
Peripheral neuropathy is a broad term that describes a lesion to a peripheral n; pt’s may exhibit motor, sensory, & autonomic changes including these, & loss of vasomotor tone

Vasomotor tone
Peripheral neuropathy is a broad term that describes a lesion to a peripheral n; pt’s may exhibit motor, sensory, & autonomic changes including extreme sensitivity to touch, loss of sensation, muscle weakness, & loss of this

DTRs
Peripheral neuropathy is a broad term that describes a lesion to a peripheral n; these may be asymmetrical based on location of involved peripheral n & usually present as diminished or absent

Asymmetrical
Peripheral neuropathy is a broad term that describes a lesion to a peripheral n; DTRs may be this based on location of involved peripheral n & usually present as diminished or absent

Diminished/absent
Peripheral neuropathy is a broad term that describes a lesion to a peripheral n; DTRs may be asymmetrical based on location of involved peripheral n & usually present as this or this

UMN
DTRs would not typically be absent w/MS since it’s this type disorder

B
You read in the medical record that x-rays confirmed presence of a reverse Hill-Sachs Fx; what injury would most likely be assoc w/this Fx? A) ant glenohumeral dislocation, B) post glenohumeral dislocation, C) RCT, D) biceps tendon rupture

Reverse Hill-Sachs Fx/lesion
This/this is an impaction Fx of the ant medial HH; mgmt of the injury is primarily based on size of impression defect

Ant medial HH
A reverse Hill-Sachs Fx/lesion is an impaction Fx of this

Size of impression defect
A reverse Hill-Sachs Fx/lesion is an impaction Fx of the ant medial HH; mgmt of the injury is primarily based on this

Hill-Sachs Fx/lesion
This/this is characterized as impaction Fx of post sup HH & freq Dx in pt’s who’ve repeatedly sustained ant GH dislocations; approx 95% of dislocations occur in ant direction

Post sup HH
A Hill-Sachs Fx/lesion is characterized as impaction Fx of this & freq Dx in pt’s who’ve repeatedly sustained ant GH dislocations; approx 95% of dislocations occur in ant direction

Repeatedly sustained ant GH dislocations
A Hill-Sachs Fx/lesion is characterized as impaction Fx of post sup HH & freq Dx in pt’s who’ve done this; approx 95% of dislocations occur in ant direction

IR/adduction
A reverse Hill-Sachs Fx is typically assoc w/post GH dislocation; pt’s w/a post GH dislocation typically present holding their arm in these positions & may exhibit flattening of ant shoulder & prominent coracoid process

Flattening of ant shoulder/prominent coracoid process
A reverse Hill-Sachs Fx is typically assoc w/post GH dislocation; pt’s w/a post GH dislocation typically present holding their arm in IR/adduction & may exhibit these

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