So, Krishyra B.

BSPT
INTERN02 UPPER EXTREMITY CONDITIONS 1

Condition Definition Etiology Epidemiology Pathophysiology Signs & Complications PT PT DDx Medical Mx &
Symptoms Assessment Management Assessment
Clavicular Break in - FOOSH M>F The clavicle is - Sagging of the - Post - Outcome Acute: Correlate - X-ray
Fracture clavicle or - Trauma easily fractured shoulder traumatic measure: - Pain with other (bones)
collarbone - Fall onto the lateral shoulder Middle 1/3 – most common d/t its downward and arthritis DASH, management conditions - CT Scans
commonly subcutaneous forward SPADI - Gentle listed (bones & soft
in middle Lateral 1/3 – more common location and - Inability to lift - Difficulty mobilization tissues) less
portion or multiple the arm because breathing - Isometrics detailed than
shaft of the Medial 1/3 – least common attachments in of pain MRI
bone. ligaments and - (+) Tenting - Subclavian Sub-acute: - MRI (soft
joints. - Bruising, vein laceration - Continued tissues,
swelling, pain organs, blood
tenderness - Brachial management vessels,
plexus - Progressive ligaments) in
compression stretching detail, used to
- PREs rule out
diseases if
Chronic: doctor
- Continued suspects any
pain further
management
(if any) Conservative
- Stretching treatment –
towards end less recovery
range time
- PREs
- Functional Surgical
training treatment –
more
recovery time
AC joint Stress, - Trauma (direct blow to shoulder in adduction) - Athletes Excessive - (+) Step - Midclavicular, - O’brien Test Acute: Correlate - X-ray
sprain and partial tear - Overuse - Fall risk patient stress through deformity distal = SLAP II - Pain with other (bones)
or rupture - People with weak balance trauma - Abrasions clavicular, - Horizontal management conditions - CT Scans
of the AC and proprioception compromise the - Pain, acromial, and Adduction - Gentle listed (bones & soft
or SC - People who age of 20-25 ligaments tenderness, coracoid Test mobilization tissues) less
ligaments swelling fractures. - Scarf Test - Isometrics detailed than
- Symptomatic MRI
traumatic Painful Arc Sub-acute: - MRI (soft
arthritis for i. 0-60: (-) - Continued tissues,
type 1 and 2 of Pain – muscle pain organs, blood
AC tear; management vessels,
- Impingement dislocation - Progressive ligaments) in
symptoms ii. 60-120: (+) stretching detail, used to
- Soft-tissue Pain; GH - PREs rule out
ossification Impingement diseases if
- Malunion & Tendinitis Chronic: doctor
iii. 120-170: - Continued suspects any
So, Krishyra B. BSPT
INTERN02 UPPER EXTREMITY CONDITIONS 1

(-) Pain pain further

iv. 170-180: management
AC Jt (if any) Conservative
- Stretching treatment –
towards end less recovery
range time
- PREs
- Functional Surgical
training treatment –
more
recovery time
SC joint Stress, -F>M Excessive - Pain, - Midclavicular, - Palpation Acute: Correlate - X-ray
sprain partial tear - Traumatic stress through tenderness, distal - Breathing - Pain with other (bones)
or rupture - Atraumatic (inflammatory arthritis, gout, Anterior: Most Common trauma swelling clavicular, assessment management conditions - CT Scans
of the AC pseudogout) (2/3rd) compromise the - Affected side = acromial, and - Gentle listed (bones & soft
or SC ligaments shorter shoulder coracoid mobilization tissues) less
ligaments Posterior: rare fractures. - Isometrics detailed than
Posterior: - Symptomatic MRI
- Impingement traumatic Sub-acute: - MRI (soft
of other vascular arthritis for - Continued tissues,
structures type 1 and 2 of pain organs, blood
- Difficulty in AC management vessels,
breathing & - Impingement - Progressive ligaments) in
swallowing symptoms stretching detail, used to
- Soft-tissue - PREs rule out
ossification diseases if
- Malunion Chronic: doctor
- Continued suspects any
pain further
management
(if any)
- Stretching Conservative
towards end treatment –
range less recovery
- PREs time
- Functional
training Surgical
treatment –
more
recovery time
Sprengel’s Also known - Idiopathic -F>M The scapula - Hallmark sign: - Lifelong - Ocular Mobilization of - Klippel - X-ray
Deformity as - Genetic - Most common congenital then migrates LOM of deformity if left Inspection the shoulder Feil (bones)
th th
Eulenberg’ - Problems during fetal development (9 to 12 anomaly in the scapula down to its adult Abduction untreated and scapula Syndrome - CT Scans
s Disease, week) position by birth - Asymmetry in - Scoliosis (bones & soft
it is the to T2-T7 during the shoulder Strengthening - Torticollis tissues) less
abnormal the 3rd month alignment. exercises detailed than
elevation of of gestation. Underdeveloped MRI
So, Krishyra B. BSPT
INTERN02 UPPER EXTREMITY CONDITIONS 1

the scapula Those who muscles Stretching - MRI (soft

have Sprengel’s - LOM in Exercises tissues,
Deformity this shoulder & neck organs, blood
migration fails - (+) vessels,
to occur. Omovertebral ligaments) in
bone detail, used to
rule out
diseases if
doctor
suspects any
further

Surgery –
removal of
omovertebral
bone,
resectioning
of scapula
Scapular Displacem - Injury to LTN (medial winging) = open book -F>M Radical - Upper back or - GH Instability Medial Stretching Correlate - X-ray
Winging ent of the - Injury to Spinal Accessory Nerve (lateral mastectomy shoulder pain - Chronic Winging: scapular with other (bones)
scapula winging) = sliding door (medial - Muscle Fatigue periscapular, - Punch Out stabilizers and conditions - CT Scans
medially or winging) or - Shoulder upper back Test shoulder listed (bones & soft
laterally surgery to the Weakness and shoulder - Wall Push capsules tissues) less
from its posterior neck pain Up detailed than
anatomical triangle (lateral - Secondary - Shoulder Strengthening MRI
position winging) can impingement flexion scapular - MRI (soft
damage the syndromes stabilizers, tissues,
associated Lateral cervical organs, blood
nerves Winging: muscles and vessels,
- Shoulder shoulder ligaments) in
abduction capsules detail, used to
rule out
Isometric diseases if
strengthening doctor
suspects any
NMES to further
prevent
atrophy Electromyogr
aphy et nerve
Re-education conduction
of functional studies
glenohumeral
and
scapulothoraci
c muscle
patterns
So, Krishyra B. BSPT
INTERN02 UPPER EXTREMITY CONDITIONS 1

Shoulder Separation - Anterior dislocation (most Extreme ANTERIOR Refer to table - NPRS Acute: Correlate - X-ray
Dislocation of the common) movements or DISLOCATION in etiology - ROM, MMT - Pain with other (bones)
humerus - Posterior dislocation (more force in the (humeral head - DASH management conditions - CT Scans
from the common) associated MOI comes to lie - Quick DASH - Gentle listed (bones & soft
glenoid of - Inferior dislocation (least positions. anterior, medial - SPADI mobilization tissues) less
the scapula common) and slightly - Isometrics detailed than
at the - There is a strong traumatic blow to the inferior to its Anterior MRI
glenohume shoulder joint normal location Drawer Test Sub-acute: - MRI (soft
ral joint - Extreme rotation and glenoid - Continued tissues,
- Contact sports fossa). Posterior pain organs, blood
- MVA - Arm held in an Drawer Test management vessels,
- Genetically lax joints abducted and - Progressive ligaments) in
ER position Others: stretching detail, used to
- Loss of normal Circumductio - PREs rule out
contour of the n Test diseases if
deltoid and Chronic: doctor
acromion Load and - Continued suspects any
prominent Shift pain further
posteriorly and management
laterally (if any) Electromyogr
- Humeral head - Stretching aphy et nerve
palpable towards end conduction
anteriorly range studies
- LOM c pain in - PREs
AP - Functional
training

POSTERIOR
DISLOCATION
- Arm is
abducted and IR
- May notice
posterior
prominence
head of
humerus

Shoulder A common - Athletic populations - Decreased - Pain in - Long term HENDY Acute: Correlate - X-ray
Impingement cause of - Populations who make use of subacromial Overhead/reachi pain (Hawkin’s - Pain with other (bones)
shoulder frequent overhead activity space -> ng motions - Bursitis Kennedy, management conditions - CT Scans
pain irritation of - Pain et - Frozen Empty Can, - Gentle listed (bones & soft
wherein subacromial tenderness in shoulder Neer’s, Drop mobilization tissues) less
there is an bursa -> pain d/t the anterior Arm, Yocum) - Isometrics detailed than
irritation of - Overuse from repetitive activity of shoulder impingement of shoulder - PJM MRI
the - Age-related wear and tear structures - Pain when - MRI (soft
subacromia - Inflammation or hypertrophy of surrounding lying on affected Sub-acute: tissues,
l bursa side - Continued organs, blood
So, Krishyra B. BSPT
INTERN02 UPPER EXTREMITY CONDITIONS 1

structures - Nocturnal pain pain vessels,

- Age-related bone spurs on acromion - Pain when management ligaments) in
reaching behind - Progressive detail, used to
your back stretching rule out
(reaching back - PREs diseases if
pocket) doctor
- Shoulder et/or Chronic: suspects any
arm weakness - Continued further
et stiffness pain
management
(if any)
- Stretching
towards end
range
- PREs
- Functional
training
Rotator Cuff Inflammatio -M>F Repeated - Pain in the - Rotator cuff HENDY Acute: Correlate - X-ray
Tendinitis n of the - One of the most common overhead & shoulder, which tear (Hawkin’s - Pain with other (bones)
tendons shoulder pathologies rotatory may be worse - Shoulder Kennedy, management conditions - CT Scans
that make miovements -> with overhead impingement Empty Can, - Gentle listed (bones & soft
up the Supraspinatus Tendinitis / Swimmer’s microtears/infla movements or syndrome Neer’s, Drop mobilization tissues) less
rotator cuff Shoulder- mmation -> pain lifting - Chronic pain Arm, Yocum) - Isometrics detailed than
(supraspin Freestyle butterfly FIR movements - Tenderness or - Atrophy MRI
atus, swelling in the Sub-acute: - MRI (soft
infraspinatu affected area - Continued tissues,
s, teres - Weakness in pain organs, blood
minor, and the affected arm management vessels,
subscapula or shoulder - Progressive ligaments) in
ris.) - LOM stretching detail, used to
- Cracking or - PREs rule out
popping sounds diseases if
in the shoulder Chronic: doctor
during - Continued suspects any
movement pain further
- Difficulty management
sleeping on the (if any)
affected - Stretching
shoulder towards end
- Pain or range
discomfort that - PREs
may radiate - Functional
down the arm training

Bicipital Inflammatio - Wear and tear d/t overuse - Athletic populations Repetitive - Pain or - Arthritis of Speed’s Test Acute: Correlate - X-ray
nd
Tendinitis n of the - Degenerative changes - 2 most common cause of shoulder tenderness in the shoulder - Bicipital - Pain with other (bones)
long head - Laxity of transverse humeral ligament shoulder pain movements -> the front of the joint. Tendinits management conditions - CT Scans
So, Krishyra B. BSPT
INTERN02 UPPER EXTREMITY CONDITIONS 1

of the inflammation shoulder - Shoulder - Gentle listed (bones & soft

biceps - Pain or impingement Ludington mobilization tissues) less
tendon. achiness that - Tendon Test – bieps - Isometrics detailed than
moves down the rupture tendon test + MRI
upper arm bone popeye sign Sub-acute: - MRI (soft
- An occasional - Continued tissues,
snapping sound Yergason’s pain organs, blood
or sensation in Test – management vessels,
the shoulder integrity of - Progressive ligaments) in
ligament stretching detail, used to
- PREs rule out
diseases if
Chronic: doctor
- Continued suspects any
pain further
management
(if any)
- Stretching
towards end
range
- PREs
- Functional
training
Frozen Involves - People 40 et older Thickening of Refer to table - Residual pain Apley’s Acute: Correlate - X-ray
Shoulder stiffness et -F>M joint capsule -> below - Residual Scratch Test - Pain with other (bones)
pain in the - Non-dominant shoulder is ERABIR stiffness management conditions - CT Scans
shoulder more prone to be limitation Shoulder - Gentle listed (bones & soft
joint affected Shrug Sign mobilization tissues) less
which - Isometrics detailed than
typically - PJM MRI
may begin - MRI (soft
slowly, Sub-acute: tissues,
then get - Continued organs, blood
worse. pain vessels,
management ligaments) in
- Progressive detail, used to
stretching rule out
- PREs diseases if
doctor
Chronic: suspects any
- Continued further
pain
management Conservative
(if any) treatment –
- Stretching less recovery
towards end time
range
So, Krishyra B. BSPT
INTERN02 UPPER EXTREMITY CONDITIONS 1

- PREs Surgical
- Functional treatment –
training more
recovery time
Thoracic Compressi - Neck Trauma - Young, middle aged & older Trauma to neck Neurogenic: - Chronic arm - Military Strengthening CTS - X-ray
Outlet on of the - Scalene Anomalies adults -> compression weakness or swelling and Brace, of the levator (bones)
Syndrome neurovascu - Traction Injury numbness pain Halstead, scapulae, Cervical - CT Scans
lar - Gangrene Adson’s sternocleidom Radiculopa (bones & soft
structures Vascular: - Open sores Roo’s, astoid and thy tissues) less
that pass swelling, (ischemic Allen’s, upper detailed than
through the weakness ulcers) Wright’s trapezius MRI
thoracic - Permanent - MRI (soft
outlet Arterial: nerve damage Stretching of tissues,
Discoloration, the pectoralis, organs, blood
sensitivity lower vessels,
trapezius and ligaments) in
scalene detail, used to
muscles rule out
diseases if
Aerobic doctor
exercise suspects any
further

Conservative
treatment –
less recovery
time

Surgical
treatment –
more
recovery time