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