Pediatric emergency medicine trisk 0864 0864
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (115.95 KB, 1 trang )
FIGURE 43.4 Painful arc test for rotator cuff injury. During the painful arc test the examiner
moves the patient’s shoulder to full 180-degree abduction. If pain mainly occurs between 60
and 120 degrees, it is suggestive of rotator cuff injury. (Adapted with permission from Shatzer
M. Physical Medicine and Rehabilitation Pocketpedia . 2nd ed. Philadelphia, PA: Lippincott
Williams & Wilkins; 2012.)
Stress fractures of the proximal humeral epiphysis, or “Little League shoulder,”
are caused by repetitive internal rotation of an abducted, externally rotated
shoulder during the throwing motion. The child, usually 11 to 16 years of age, has
diffuse shoulder pain that worsens after throwing. The proximal humerus may be
tender and radiographs may show widening of the proximal humeral physis.
Radiographs of the contralateral humerus may be helpful.
In older patients, shoulder pain may be due to tendonitis of the long head of the
biceps. This tendon is palpable as it runs through the bicipital groove just anterior
and medial to the greater humeral tuberosity. The patient often has chronic pain
and tenderness over the bicipital groove.
