Shoulder pain with lifting

Shoulder pain with lifting (Full Version)

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Alex Brenner PT MPT OCS -> Shoulder pain with lifting (June 9, 2005 8:48:00 PM)
25 year old male complains of shoulder pain especially with bench press in the gym or when doing push ups. He has had the pain for 3 years and has point tenderness. Disregard the dog tag chain that our radiology tech failed to remove. What are the findings? [IMG]http://img.photobucket.com/albums/v85/brennerak/sh3.jpg[/IMG] [IMG]http://img.photobucket.com/albums/v85/brennerak/sh1.jpg[/IMG] [IMG]http://img.photobucket.com/albums/v85/brennerak/sh2.jpg[/IMG]

pablo w -> Re: Shoulder pain with lifting (June 9, 2005 9:00:00 PM)
On the last film, it looks as though the humerus is adducted across the body, and the AC joint looks as if it is out of alignment. Maybe the scapula is moving anterior to the clavicle at the AC joint and this only ahppens with shoulder protraction as in the final stage of the bench press? Or maybe it is just because I am not used to that particular view? Pablo

PTupdate.com -> Re: Shoulder pain with lifting (June 10, 2005 2:23:00 AM)
I would suggest osteolysis of the distal clavicle. John Duffy, PT OCS [URL=http://www.PTupdate.com]www.PTupdate.com[/URL]

JLS_PT_OCS -> Re: Shoulder pain with lifting (June 10, 2005 2:52:00 AM)
I agree with John D. I think he has AC arthrosis and/or osteolysis of distal clavicle. Pablo- last view is an "outlet" view, designed to give you an idea of his acromion morphology. He has a Type I acromion. J

Synergy -> Re: Shoulder pain with lifting (June 10, 2005 2:40:00 PM)
What is that ovoid area inside the superior glenoid in the first two films?

jma -> Re: Shoulder pain with lifting (June 10, 2005 3:18:00 PM)
Isn't the outlet view also used for detecting anterior or posterior humeral dislocation as well?

MPTSTUDENT -> Re: Shoulder pain with lifting (June 12, 2005 6:09:00 AM)
I dont really see anything here but I usually dont. I have a question for you guys though. Where have all of you PTs learned so much about x-rays? Did you learn this in school or has it been continuing ed courses? I have a semester of classes left and we have not covered reading x-rays and we wont that I know of? I try to come and look at the image on here each week and sometimes I can spot it but more then often I cannot until Army circles it. Sometimes I cannot even tell what type of view I am looking at or what something is. Also, I sometimes see something wrong that isnt really wrong. I guess it would help if I have seen what "normal" films look like.

greatdc -> Re: Shoulder pain with lifting (June 12, 2005 7:26:00 AM)
Looks like a grade III AC jt sprain

srcase -> Re: Shoulder pain with lifting (June 12, 2005 10:22:00 AM)
That's what I thought too. AC joint separation.

jma -> Re: Shoulder pain with lifting (June 12, 2005 2:38:00 PM)
Had one long lecture on it during school. Took the APTA radiology course on it after graduating and took a semester course on it for the t-DPT.

PTupdate.com -> Re: Shoulder pain with lifting (June 12, 2005 4:44:00 PM)
MPTSTUDENT, there are now courses offered for PT's to learn some of the basics when it comes to radiographs and MRI. This site has some good info: http://www.ptcentral.com/radiology/ Most of the journals I read are physician based, and therefore always include diagnostic images with specifics pointed out. With PCP's becoming gate keepers over the past 5 years, many journals are geared towards helping them learn the process also. Take some time to spend with an orthopod...I do this a TON. They are almost alwasys glad to teach you something. Take a half vacation day and spend it with an ortho surgeon, either in the OR learning or just viewing xrays with him/her....trust me, a doc would prefer to send patients to a PT that demonstrates he gives a da-- John Duffy, PT OCS [URL=http://www.PTupdate.com]www.PTupdate.com[/URL]

jma -> Re: Shoulder pain with lifting (June 12, 2005 5:42:00 PM)
Yes, ptcentral has a great course. Here are links to two other sites that were recommended to me while I took the APTA course: http://www.vh.org/adult/provider/radiology/NormalRadAnatomy/index.html http://www.skeletalrad.org/teachingfiles.htm JMA

Alex Brenner PT MPT OCS -> Re: Shoulder pain with lifting (June 12, 2005 7:16:00 PM)
You could also spend the day with a radiologist. Radiologist work pretty much in solitude and I bet would be happy to have someone sit in their dark room with them. And like anything else, the more you look at them the better you get. At my last hospital, we would have our PT students spend one to two days with our radiologist looking at films all day long. Fun,fun. On your next affiliation you could request this of your CI.

JLS_PT_OCS -> Re: Shoulder pain with lifting (June 13, 2005 1:49:00 AM)
Yes, I have found radiologists very helpful, and you may likely get more film reading that way than by following an Ortho. Though, as John D pointed out, radiologists don't refer patients! J

Condis -> Re: Shoulder pain with lifting (June 15, 2005 7:32:00 PM)
My vote is for a grade II separation.

Synergy -> Re: Shoulder pain with lifting (June 16, 2005 7:42:00 AM)
"Weight lifters" AC joint arthritis.

Alex Brenner PT MPT OCS -> Re: Shoulder pain with lifting (June 18, 2005 7:41:00 AM)
Findings: Mild to moderate spurring in the bicipital groove. No other abnormalities. The patient was point tender in the bicipital groove.

jma -> Re: Shoulder pain with lifting (June 18, 2005 12:55:00 PM)
Very interesting. Can you point out the spurring in the bicipital groove. I think it would appear more clear on the outlet view, right?

greatdc -> Re: Shoulder pain with lifting (June 18, 2005 4:21:00 PM)

Alex Brenner PT MPT OCS -> Re: Shoulder pain with lifting (June 19, 2005 10:59:00 PM)
[IMG]http://img.photobucket.com/albums/v85/brennerak/sh1edit2.jpg[/IMG]

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