PHTY207 week 2 theory GHJ pathologies

What does RCRSP stand for?

Rotator cuff-related shoulder pain

What diagnostic category does RCRSP typically fall under?

Pain and weakness

What is the typical pain location in RCRSP?

Anterolateral shoulder

What happens to PROM in many patients with RCRSP?

It is relatively preserved

What are the three stages of rotator cuff tendinopathy?

Reactive tendon; tendon disrepair; degenerative tendon

What occurs during reactive tendinopathy?

Tendon swelling and oedema in response to loading

What occurs during tendon disrepair?

Fibrosis and structural changes within the tendon

What occurs during degenerative tendinopathy?

Substantial tendon degeneration with possible tearing

What are two important prognostic factors for rotator cuff tears?

Tear size and number of tendons involved

How can a large rotator cuff tear affect GHJ biomechanics?

Reduced compressive stability and possible anterosuperior humeral head migration

Why should imaging findings be interpreted alongside clinical assessment?

Structural changes may be asymptomatic

What does GIRD stand for?

Glenohumeral Internal Rotation Deficit

What side-to-side IR difference is highlighted in the lecture for GIRD?

Greater than 20 degrees

Which athletes commonly demonstrate GIRD?

Overhead throwing athletes

What are two potential mechanisms contributing to GIRD?

Bony adaptation and posterior shoulder tightness

How is total shoulder rotational ROM calculated?

Internal rotation plus external rotation

Why is total rotational ROM important when assessing GIRD?

Reduced IR may be compensated by increased ER

When might reduced IR represent a normal sporting adaptation?

When total rotational ROM is preserved

What is calcific tendinitis?

Calcium deposition within a rotator cuff tendon

Which tendon is most commonly affected by calcific tendinitis?

Supraspinatus

What imaging finding may indicate calcific tendinitis?

A dense calcium deposit on X-ray

What is a characteristic clinical feature of calcific tendinitis?

Potentially severe shoulder pain

What diagnostic category does GHJ OA fall under?

Pain and stiffness

What are four radiographic features of GHJ OA?

Joint space narrowing; osteophytes; sclerosis; irregular bony margins

What are common clinical features of GHJ OA?

Progressive pain and stiffness; reduced ROM; clicking or grating

How are AROM and PROM typically affected in GHJ OA?

Both may be restricted

What are common risk factors for GHJ OA?

Increasing age; previous injury; repetitive overhead activity

What is adhesive capsulitis?

Inflammation and fibrosis of the GHJ capsule causing pain and stiffness

What pathological changes occur in adhesive capsulitis?

Inflammation; fibroblast activity; capsular fibrosis and contracture

What is the characteristic ROM restriction pattern in frozen shoulder?

External rotation greater than abduction greater than internal rotation

Why is external rotation particularly restricted in frozen shoulder?

Anterior capsular contracture reduces extensibility during ER

How are AROM and PROM affected in frozen shoulder?

Both are restricted

What are four important risk factors for frozen shoulder?

Diabetes; thyroid disorders; female sex; age 40 to 60

What are the three phases of frozen shoulder?

Freezing; frozen; thawing

What dominates during the freezing phase?

Pain and progressively worsening ROM

What dominates during the frozen phase?

Stiffness with significant movement restriction

What occurs during the thawing phase?

Gradual improvement in ROM and function

What position commonly provokes anterior GHJ instability?

Abduction and external rotation

What position commonly provokes posterior GHJ instability?

Flexion and internal rotation and adduction

What does a positive anterior apprehension test indicate?

Apprehension or fear of anterior shoulder dislocation

What is multidirectional instability?

Symptomatic instability associated with excessive translation in multiple directions

What is the difference between laxity and instability?

Laxity can be asymptomatic whereas instability produces symptoms

What does SLAP stand for?

Superior Labral Anterior to Posterior

How can repetitive throwing contribute to a SLAP lesion?

Biceps torsion and eccentric deceleration load the superior labrum

What is the difference between Bankart and Hill-Sachs lesions?

Bankart affects the glenoid labrum or rim; Hill-Sachs affects the humeral head