Thursday , 23 November 2017

Shoulder

Acromioclavicular Joint Osteolysis – Stuart Wildman, Extended Scope Physiotherapist

This patient in his thirties was referred to the clinic with a six week history of left shoulder pain. On examination, there was a visible enlargement of the Acromioclavicular Joint (ACJ). He did not recall a history of trauma, but had an intensive schedule of martial arts training which involved falls onto both shoulders on a regular basis. He had trialled a course of NSAID's which had not improved his symptoms, and had rested from more intensive upper body resistance training. His general health was otherwise good, and he was not taking any regular medication. On examination, he presented with …

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Greater tuberosity fracture on musculoskeletal ultrasound – Stuart Wildman, Extended Scope Physiotherapist

I wanted to post this as I felt it was an example where quick access to ultrasound in clinic facilitated a patients management. The patient was in her late 20's, and it was six weeks after she fell off her bike and she was complaining of left shoulder pain. She landed directly onto her left shoulder without a fall on an outstretched hand. She had been to A&E where x-rays indicated no fracture. Her pain had continued hence her referral to the ESP service. On examination she presented with reduced range to approx 90 degrees abduction and flexion limited by …

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