Painful Shoulder

1- TENDONITIS:

* Sometimes appears after a progressive way effortlessly

* The tendon of the supraspinatus is most often achieved (rotator cuff)

* Pain is awakened by active abduction is limited with a painful arc below 90 °.

* The maneuver Jobbe is positive (loss of strength of the supraspinatus)

* Most often passive mobilization is little or limited

* Conventional radiography is usually normal. The glenohumeral spacing is normal

* On the other tendons can be achieved: the achievement of the subscapularis is characterized by pain triggered by internal rotation upset and a positive lift-off. The infraspinatus by external rotation

* These can be calcifying tendinitis or not

2- ACUTE SHOULDER HYPERALGIC:

* It usually corresponds to a microcrystalline bursitis

* Severe pain suddenly appeared without predisposing circumstances

* It is responsible for a total lameness

* The patient is as a traumatized upper limb (attitude Dessaut with arms close to the body, elbow flexed to 90 °, supported by the opposite hand)

* Attempting to active or passive mobilization is impossible because of the pain. There may be signs of inflammation

* The X-ray shows a picture periarticular calcium; glenohumeral spacing is normal

* If the reversal is complete there will be no recurrence can occur in case of partial resorption

3- FROZEN SHOULDER (SHRINK CAPSULE):

* It is due to a primary or secondary retractile capsulitis (CRPS)

* The main sign is the shoulder stiffness active liver but passive predominant in abduction and external rotation.

* She moved gradually and can result in a painful phase

* Pain wrist and hand may be associated in the shoulder-hand syndrome usually respect elbow

* X-rays may be normal or show demineralization of the upper end of the humerus without abnormality of the glenohumeral spacing

* It is opaque arthrography who can confirm the diagnosis (decreased joint capacity), reduced opacity and the disappearance of the inferior recess

4- SHOULDER PSEUDO PARALYTIC:

* For breaking of the rotator cuff

* The onset can be sudden or progressive after trauma (tendon altered in the elderly).

* Full or partial decrease sometimes active mobility contrasting with the conservation of passive mobilization.

* There is compensation for keeping, even with complete failure, a normal active mobility and somewhat limited.

* This diagnosis should not be made after removing a neurological

* The functional impact is minimal diagnosis is often made retrospectively

remarks:

– Any shoulder pain requires a systematic examination of the cervical spine

– The posterior topography of a scapular pain oriented more towards a cervical origin