Shoulder

Diagnosis

The three most common types of injury in the shoulder are AC Joint separations, dislocation, and tearing of the rotator cuff tendon.

The AC joint is a joint in the shoulder where the collarbone (clavicle) joins the shoulder blade (scapula). The specific part of the scapula adjacent to the clavicle is called the acromion, which is where the name AC joint is derived from. The AC Joint is not the main joint of the shoulder, which is the glenohumeral joint, which is the ball and socket joint which forms the shoulder.

Because the shoulder has the greatest range of motion of any joint in the body, it is also the most common for dislocation. Dislocation happens when the ball of the joint (humeral head) comes apart or out of alignment with the socket (glenoid). In many cases people also have whats known as subluxation, which occurs when the shoulder does not dislocate completely, and the ball returns to its normal location after pausing on the rim of the socket.

The rotator cuff is a group of four tendons and muscles that converge around the top of the humerus, the upper portion of the arm bone above the elbow. Together, they form a ”cuff” that both holds your arm in place and allows it to move in multiple directions. Too much stress on this joint can cause partial tears and swelling in the tendons of the rotator cuff. Abrupt stress may even cause one of the tendons to pull away from the bone or tear in the middle of the tendon.

Symptoms

When an AC Joint separation occurs, it is immediately accompanied by significant pain in the shoulder, as well as limited movement and range of motion in that joint. It will often be accompanied by swelling and bruising after the injury, tenderness at the formation of the joint, and a possible deformity at the outer portion of the collarbone. In some cases, a bump or malformation may become visible on top of the shoulder.

When a shoulder dislocation or subluxation occurs, it is also accompanied by severe pain in the joint. There is almost limited to no range of motion possible in the shoulder once it is dislocated. Often times, when touching the joint from the side (around the deltoid muscle) it will have a mushy feeling as if the humeral head (which lies underneath) is displaced toward the front of the shoulder.

Symptoms of a rotator cuff tear include somewhat constant pain and weakness in the shoulder. The pain is often on the side and front of the upper arm and around the shoulder. Because it creates a limited range of motion in the shoulder, it often will be difficult to reach over your head or towards your back. Pain is often also intensified while doing more mundane activities where the shoulder gets little movement or motion (such as sleeping).

Arthroscopy of the Shoulder

If your physician recommends arthroscopic surgery for your shoulder problem, you can expect it to be performed as an outpatient (same day) procedure. You may have certain lab tests on the day of surgery, and you will be instructed not to eat or drink anything after midnight of the night before your arthroscopic procedure. More than likely you will be given a general anesthetic, which will put you to sleep during the surgery. The procedure itself usually takes from one to two hours. Your doctor will use an arthroscope (miniature telescope) to view your should joint. Using extremely small instruments, he will then make tiny incisions and perform the corrective measures dictated by your particular injury. Next, the incisions will be stitched or taped and bandaged for protections.