Post on 30-Mar-2015
Department of Traumatology Department of Traumatology and Hand Surgeryand Hand Surgery
Department of Traumatology Department of Traumatology and Hand Surgeryand Hand Surgery
University of Medical SciencesUniversity of Medical Sciences in Poznan in PoznanUniversity of Medical SciencesUniversity of Medical Sciences in Poznan in Poznan
Head of Department:Head of Department:Prof. Władysław ManikowskiProf. Władysław ManikowskiHead of Department:Head of Department:Prof. Władysław ManikowskiProf. Władysław Manikowski
Przemysław Lubiatowski MD, PhDPrzemysław Lubiatowski MD, PhD
Upper Extremity
Examination
Upper Extremity
Examination
Taking history
Physical examination
Taking history
Physical examination
EXAMINATIONEXAMINATIONEXAMINATIONEXAMINATION
Taking historyTaking history
Knowledge of the disease process
Main complaints (pain)
Onset, Duration
Dominant hand
Prior therapy
Knowledge of the disease process
Main complaints (pain)
Onset, Duration
Dominant hand
Prior therapy
EXAMINATIONEXAMINATIONEXAMINATIONEXAMINATION
Physical examinationPhysical examination
Look
Feel
Move
X-ray
Look
Feel
Move
X-ray
EXAMINATIONEXAMINATIONEXAMINATIONEXAMINATION
Main complaint- pain- instability
- stiffness, limitation of ROM, snapping, crepitation
Age> 70 y.o.< 30 y.o.
Onset of symptomsTreatment
Main complaint- pain- instability
- stiffness, limitation of ROM, snapping, crepitation
Age> 70 y.o.< 30 y.o.
Onset of symptomsTreatment
Rotator cuff tearRotator cuff tear
instabilityinstability
HISTORYHISTORYHISTORYHISTORY
Main complaint- pain- instability
- stiffness, limitation of ROM, snapping, crepitation
Age> 70 y.o.< 30 y.o.
Onset of symptomsTreatment
Main complaint- pain- instability
- stiffness, limitation of ROM, snapping, crepitation
Age> 70 y.o.< 30 y.o.
Onset of symptomsTreatment
Rotator cuff tearRotator cuff tear
instabilityinstability
HISTORYHISTORYHISTORYHISTORY
Main complaint- pain- instability
- stiffness, limitation of ROM, snapping, crepitation
Age> 70 y.o.< 30 y.o.
Onset of symptomsTreatment
Main complaint- pain- instability
- stiffness, limitation of ROM, snapping, crepitation
Age> 70 y.o.< 30 y.o.
Onset of symptomsTreatment
Rotator cuff tearRotator cuff tear
instabilityinstability
HISTORYHISTORYHISTORYHISTORY
Evaluation systems
specific
- Simple Shoulder Test
- UCLA
- ASES
general health
- SF-36
Evaluation systems
specific
- Simple Shoulder Test
- UCLA
- ASES
general health
- SF-36
HISTORYHISTORYHISTORYHISTORY
Painac. to ASES
Painac. to ASES
HISTORYHISTORYHISTORYHISTORY
Do you have pain in your shoulder ? Yes no
Mark location of pain
Do you have pain at night ? yes no
Do you take pain killers ? yes no
Do you take narcotic drugs ? Yes no
How many tablets per day ? Quantity
How severe is you pain ?
no as severe as possible
0 10
Instabilityac. to ASES
Instabilityac. to ASES
Do you have feeling of instability ? (as if your shoulder would drop of)
Yes No
How unstable is your shoulder (mark the line) ?
very very
stable unstable
0 10
HISTORYHISTORYHISTORYHISTORY
Look
Palpation
Look
Palpation
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
Range of motionRange of motion
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
Range of motionRange of motion
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
Range of motionRange of motion
0
0 –1 cm
1 - 2 cm
> 2 cm
Instability drawer test
- anterior
- sitting, laying
Instability drawer test
- anterior
- sitting, laying
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
Instability sulcus sign- sitting, laying
Instability sulcus sign- sitting, laying
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
Instability
Evaluation under anesthesia
Instability
Evaluation under anesthesia
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
Instability (apprehension test)- sitting, laying
Instability (apprehension test)- sitting, laying
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
Instability (relocation test)- sitting, laying
Instability (relocation test)- sitting, laying
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
Impingement syndrome
Neer’s Test
Impingement syndrome
Neer’s Test
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
Impingement syndrome
Hawkins’ Test
Impingement syndrome
Hawkins’ Test
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
Impingement syndrome
Painful arch test
Impingement syndrome
Painful arch test
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION
lidocaine
Test with lidocaine
Impingement syndrome (biceps brachii)
Yergason’s Test Speed Test
Impingement syndrome (biceps brachii)
Yergason’s Test Speed Test
PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION