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Shoulder Pain 

DOOEEEE!!!!!!. Shoulder Pain . 2 day old infant of diabetic mom with asymmetric Moro reflex during Dubowitz exam. Clavicle fracture. Most common pediatric fracture (most occuring before age 7) Fall onto outstretched hand, direct impact, shoulder dystocia

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Shoulder Pain 

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  1. DOOEEEE!!!!!! Shoulder Pain 

  2. 2 day old infant of diabetic mom with asymmetric Moro reflex during Dubowitz exam.

  3. Clavicle fracture • Most common pediatric fracture (most occuring before age 7) • Fall onto outstretched hand, direct impact, shoulder dystocia • Children heal quickly (adults…not always) • PE : pain, swelling, crepitus, asymmetric Moro (in neonates) • Check distal pulses, focal neuro exam, and lungs (for pneumothorax)

  4. 19 yo Polo player hurts his shoulder when he falls off his horse

  5. Acromioclavicular (AC) separation • Usually from falls onto shoulder but sometimes from fall onto outstretched arm • Seen in football, rugby, • PE: may see AC joint widened (can use 10lb weight to widen gap) • Patient often holds arm close to chest (to decrease rotation/elevation)

  6. 24 yo baseball player develops shoulder pain after pitching 9 innings(….shocker)

  7. SLAP injury

  8. SLAP injury • (Superior labrum anterior posterior) • Etiology: • Traction injury – overhead pitching (sudden ctx of biceps) • Compression injury – falling and then catching yourself ( humeral head compresses labrum) • Pt. may sometimes complain of clicking sensation in shoulder

  9. 53 yo with progressively worsening shoulder pain for 2 years and limited range of motion

  10. Rotator Cuff injuries

  11. Rotator cuff injuries • Usually from chronic overuse • SITS (supraspinatus, _________, _____ _____, __________) • Any of these can become weakened and tear but most common is the __________ • Rare below age of 40 • Related to chronic impingement of tendons in 95% of cases

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