 Many patients come into
our office complaining of Rotator Cuff Tears, when in fact
very few actually have a tear. There are several
etiologies to shoulder pain; Adhesive Capsulitis (frozen
shoulder), Subacromial Bursitis, Supraspinatus Tendonitis,
Glenohumeral Instability, Chondrocalcinosis, Osteoarthritis,
Gout, Lyme Arthritis, Bicipital Tendonitis, Ganglion Cyst
are but a few possible causes of shoulder pain. It
is best to think of cause of injury/pain and age in
making generalizations for diagnosing shoulder pain.
Cause of Injury/Pain
Overuse
-
Subacromial bursitis
-
Supraspinatus tendonitis
-
Bicipital tendonitis
-
Impingement syndrome
Forceful Trauma
-
Glenhumeral instability
-
Adhesive capsulitis
-
Fracture
-
Rotator cuff tear
Insidious Onset
-
Lyme Arthritis
-
Adhesive capsulitis
-
Ganglion cyst
-
Tumor
Chronic
-
Gout
-
Condrocalcinosis
-
Osteoarthritis
-
Rotator cuff tear
Age
YOUNGER |
Glenohumeral
instability
Subacromial bursitis
Supraspinatus tendonitis
Bicipital tendonitis
Impingement syndrome
Ganglion cyst
Lyme Arthritis
Adhesive capsulitis
Chrondrocalcinosis
Gout
Rotator cuff tear
Osteoarthritis |
¯ |
OLDER |
Diagnosing Shoulder Problems
The art of diagnosing shoulder problems
is to relate the two above with a good history from the patient
and a comprehensive shoulder exam. Believe it or not,
there are over 50 shoulder exam tests that can be done by the
examining physician alone, without the use of x-rays, MRI's,
or arthrograms. The latter test may be used to confirm
a clinical suspicion or in difficult cases, to aid in the diagnosis,
but a patient's history of injury/pain and a good shoulder
directed physical examination will usually suffice in making
a diagnosis and treatment plan. Many of these problems
are approached in a non-operative manner with medications,
rest, ice, and physical therapy suplemented with cortisone
injections on occasion. If an operation is needed, most
of these conditions can be treated by arthroscopic (scope)
techniques, with limited incisions and usually done as a same
day surgery.
Initiating early treatment for shoulder
problems is often the best curative course. If you recognize
these symptoms, you should make a prompt appointment to have
it evaluated further by your primary care physician or an orthopedic
surgeon.
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