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Saturday AM Sports/Orthopedic Clinic

Saturday AM Sports/Orthopedic Clinic. Presentation. Left Shoulder pain. Name some reasons for shoulder pain ?. Causes of shoulder pain. Suprascapular nerve entrapement Shoulder instability Thoracic outlet syndrome Cervical radiculitis Bicipital tendonitis r otator cuff disease.

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Saturday AM Sports/Orthopedic Clinic

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  1. Saturday AM Sports/Orthopedic Clinic

  2. Presentation • Left Shoulder pain

  3. Name some reasons for shoulder pain?

  4. Causes of shoulder pain • Suprascapularnerve entrapement • Shoulder instability • Thoracic outlet syndrome • Cervical radiculitis • Bicipitaltendonitis • rotator cuff disease

  5. Name all of the joints involved in the shoulder girdle complex?

  6. 7 Joints in Shoulder Girdle Complex • GH Joint • Suprahumeraljoint • AC Joint • Scapulocostaljt • Sternoclavicular joint • Sternocostaljt • Costovertebral joint

  7. Unstable joint? • What structures causes the shoulder (glenohumeral) joint to be highly mobile but relatively stable

  8. The relatively poor bony congruence between the gleniodand humeral head and a slack capsule

  9. What structure provides the strongest support for the AC joint?

  10. The coracoclavicular ligament which descends from the distal clavicle to the coracoid process. The ligament must be torn to produce the major stepdown of the acromion below the clavicle in grade 3 acromioclavicular joint injuries

  11. What other causes of shoulder pain?

  12. Can the pain be referred?

  13. What else?

  14. Pale • Clammy • Pain in epigastrum

  15. Positive Kehr’sSign What is it?

  16. Left shoulder pain • Free intraperitoneal blood • Diaphragmatic irritation

  17. Kehr’s Sign, neglected aid in rupture of the spleen New England Journal of Medicine

  18. Name some other symptoms of spleen injury?

  19. Splenic Injury • Generalize abdominal pain • Left shoulder pain • Aggravated by deep pressure of left hypochondrium • Tenderness to rectal palpation • Slight increase in temperature • FAST test

  20. What is the most commonly injured viscous in blunt trauma?

  21. Spleen the most commonly injured viscous in blunt abdominal trauma

  22. Delayed rupture presenting as unstable angina pectoralis

  23. What causes a delayed rupture spleen?

  24. Causes of the delayed bleed? • Tamponade (old blood clots) • Subscapular hemorrhage • Small tamponade forms clot on omentum or bowel laceration • Subscapular hemorrhage may be present for several days before rupture of the capsule takes place

  25. How long can the delayed rupture occur?

  26. Delayed • Less than an hour and Up to 14 days • Several months • 21% delayed

  27. Journal of Trauma 2008 • 673 non operative spleen • Mild – 12.5 heal • Severe – 37 days • 20% not heal after 3 months • 10% worse as outpatient

  28. What is the mortality?

  29. Mortality of a simple spleen rupture is 1%

  30. When would allow the player to return to sports?

  31. Full return not until 6 months

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