Patologia do ombro

Patologia do ombro

Fracturas

As fracturas podem envolver a clavícula, colo do úmero e omoplata

A clavícula é o osso do organismo que mais se fractura

Há um ponto fraco a a 1/3 da extremidade externa. Nesta fractura a espádua o osso tende a descer

As fracturas da clavícula e do colo do úmero são provocadas em geral por quedas, colisões ou acidentes de automóvelComo a omoplata está protegida pelo tórax e músculos circundantes, a sua fractura é rara, podendo observar-se em acidentes de automovel, quase sempre associada a lesões do tórax

Fracturas da clavícula

http://www.emedx.com/emedx/diagnosis_information/shoulder_disorders/collarbone_fracture_outline.htm

http://orthoinfo.aaos.org/topic.cfm?topic=A00072

https://en.wikipedia.org/wiki/Clavicle_fracture

http://www.ncemi.org/cse/cse0903.htm

http://www.emedicinehealth.com/broken_collarbone/article_em.htm

http://kidshealth.org/en/teens/clavicle-fracture.html

http://www.aafp.org/afp/2008/0101/p65.html

http://patient.info/doctor/clavicle-fracture

http://www.mayoclinic.org/diseases-conditions/broken-collarbone/basics/definition/con-20035171

http://radiopaedia.org/articles/clavicular-fracture

Fractura da omoplata

http://orthoinfo.aaos.org/topic.cfm?topic=A00359

http://www.chups.jussieu.fr/polys/orthopedie/polyortho/POLY.Chp.1.4.html

http://emedicine.medscape.com/article/1263076-treatment

http://emedicine.medscape.com/article/826084-overview

http://radiopaedia.org/articles/scapular-fracture

http://www.orthobullets.com/trauma/1013/scapula-fractures

https://www.shoulderdoc.co.uk/article/639

https: http://www.wheelessonline.com/ortho/scapular_fractures//www.shoulderdoc.co.uk/article/1454

Fractura do úmero proximal

http://www.emedx.com/emedx/diagnosis_information/shoulder_disorders/proximal_humerus_fracture_outline.htm

http://emedicine.medscape.com/article/1261320-overview

http://www.wheelessonline.com/ortho/proximal_humeral_fracture

https://www.shoulderdoc.co.uk/article/735

http://www.orthobullets.com/trauma/1015/proximal-humerus-fractures

http://radiopaedia.org/articles/proximal-humeral-fracture-classification-neer-1

http://radiopaedia.org/articles/proximal-humeral-fracture-1

https://www2.aofoundation.org/wps/portal/surgery?showPage=diagnosis&bone=Humerus&segment=Proximal

Instabilidade da espadua

http://www.orthogate.org/patient-education/shoulder/shoulder-

http://www.aafp.org/afp/1999/0515/p2773.html

http://orthoinfo.aaos.org/topic.cfm?topic=a00529

Left: Normal shoulder stability. Right: Head of the humerus dislocated to the front of the shoulder.

http://www.orthop.washington.edu/?q=patient-care/articles/shoulder/atraumatic-shoulder-instability.html

http://www.orthop.washington.edu/?q=patient-care/articles/shoulder/home-exercises-for-the-unstable-shoulder.html

http://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/shoulder-instabilityu

http://www.houstonmethodist.org/orthopedics/where-does-it-hurt/shoulder/shoulder-instability/

http://www.miamisportsmedicine.com/ShoulderInstability.html

http://www.nemsi.uchc.edu/clinical_services/orthopaedic/shoulder/shoulder_instability.html

Luxações  da espadua

As luxações são  frequentes.

Como os tendões e ligamentos estão essencialmente nas regiões superior e anterior, nas luxações o úmero tem tendência a se deslocar para baixo

Como os principais ligamentos cruzam a face superior da articulação, é mais frequente a luxação inferior do úmero, na direcção da axila

A luxação acromio-clavicular é conhecida como espadua separada

A luxação esternoclavicular separa a clavícula do esterno

Na luxação glenohumeral a separação pode ser para diante ou para trás

http://www.shoulderpaininfo.com/shoulderDislocations.html

http://www.emedx.com/emedx/diagnosis_information/shoulder

http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=43266

http://orthoinfo.aaos.org/topic.cfm?topic=A00033&return_link=0

http://chestofbooks.com/health/anatomy/Human-Body-Construction/Dislocations-Of-The-Clavicle.html

Artrite acromioclavicular

http://orthopedics.about.com/cs/generalshoulder/a/acarthritis.htm

http://www.arthritis-health.com/types/osteoarthritis/what-acromioclavicular-arthritis-ac-joint-arthritis

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684214/

http://www.webmd.com/osteoarthritis/guide/shoulder-osteoarthritis-degenerative-arthritis-shoulder

https://www.shoulderdoc.co.uk/section/19

http://www.massgeneral.org/ortho/services/sports/rehab/Acromioclavicular%20(AC)%20joint%20patient%20information.pdf

http://www.caringmedical.com/treatment/acromioclavicular-ac-joint-arthrosis/

http://www.shouldersurgery.com.au/ac-joint-arthritis.html

http://www.medscape.com/viewarticle/826927

 Artrites da espadua

http://orthopedics.about.com/cs/generalshoulder/a/acarthritis.htm~

http://www.webmd.com/osteoarthritis/guide/shoulder-osteoarthritis-degenerative-arthritis-shoulder

http://www.healthline.com/health/osteoarthritis/shoulder-arthritis-types#Osteoarthritis3

http://www.orthop.washington.edu/?q=patient-care/shoulder-arthritis.html

http://www.arthritisresearchuk.org/arthritis-information/conditions/shoulder-pain.aspx

http://www.arthritisresearchuk.org/arthritis-information/conditions/shoulder-pain/treatments.aspx

https://www.shoulderdoc.co.uk/section/24

http://www.coreperformance.com/knowledge/injury-pain/relief-for-shoulder-arthritis.html

Bursites da espadua

A bursite infra-acromial pode tornar-se muito dolorosa quando o deltóide comprime a bolsa durante o movimento do ombro

http://www.webmd.com/pain-management/arthritis-bursitis

http://physioworks.com.au/injuries-conditions-1/bursitis_shoulder

https://en.wikipedia.org/wiki/Subacromial_bursitis

https://www.med.unc.edu/fammed/fammedcenter/about-us/services/sportsmedicine/Subacromial%20bursitis%20patients.pdf

http://www.arthritis-health.com/types/bursitis/shoulder-subacromial-bursitis

Ombro congelado

A cápsula da articulação gleno-umeral inflama-se e torna-se rígida e forma adesões que limitam grandemente os movimentos da articulação.

Esta situação dura seis meses a mais de três anos

Muitas vezes a causa é desconhecida mas nalguns casos está associada a imobilização por fractura ou a traumatismos

http://patient.info/health/frozen-shoulder-leaflet

http://orthoinfo.aaos.org/topic.cfm?topic=A00071

http://www.emedx.com/emedx/diagnosis_information/shoulder_disorders/frozen_shoulder_outline.htm

http://emedicine.medscape.com/article/326828-overview

http://www.mayoclinic.org/diseases-conditions/frozen-shoulder/basics/definition/con-20022510

http://www.medicinenet.com/frozen_shoulder/article.htm

https://www.nlm.nih.gov/medlineplus/medlineplus.html

http://www.medicalnewstoday.com/articles/166186.php

https://en.wikipedia.org/wiki/Adhesive_capsulitis_of_shoulder

https://www.nlm.nih.gov/medlineplus/ency/article/000455.htm

http://www.healthline.com/health/frozen-shoulder#RiskFactors4

https://www.shoulderdoc.co.uk/section/16

Coifa dos rotadores

http://patient.info/health/rotator-cuff-disorders

http://www.emedicinehealth.com/rotator_cuff_injury/article_em.htm

http://www.mayoclinic.org/diseases-conditions/rotator-cuff-injury/home/ovc-20126921

http://www.bupa.co.uk/health-information/directory/r/rotator-cuff-injury

http://www.medicinenet.com/rotator_cuff/article.htm

http://familydoctor.org/familydoctor/en/prevention-wellness/exercise-fitness/injury-rehab/rotator-cuff-exercises.html

http://www.emedicinehealth.com/rotator_cuff_injury/article_em.htm

http://www.mayoclinic.org/diseases-conditions/rotator-cuff-injury/home/ovc-20126921

http://physioworks.com.au/injuries-conditions-1/rotator-cuff-injuries   3/12

http://physioworks.com.au/injuries-conditions-1/rotator-cuff-tears   3/12

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Rasgao dos rotadores

http://orthoinfo.aaos.org/topic.cfm?topic=A00064

http://www.shoulderpaininfo.com/shoulderRotatorCuff.html

http://physioworks.com.au/injuries-conditions-1/rotator-cuff-tears   3/12

http://www.orthogate.org/patient-education/shoulder/rotator-cuff-tears

http://www.emedx.com/emedx/diagnosis_information/shoulder_disorders/rotatorcuff_tendonitis_tears_outline.htm

http://orthopedics.about.com/od/rotatorcuff/tp/rotatorcuff.htm

https://en.wikipedia.org/wiki/Rotator_cuff_tear

https://www.shoulderdoc.co.uk/section/22

Debrum glenoideu

Rasgao do debrum

http://orthoinfo.aaos.org/topic.cfm?topic=A00426

http://www.shoulderpaininfo.com/shoulderLabrum.html

http://www.orthogate.org/patient-education/sDepositos de calcio na espaduahoulder/labral-tears

http://www.emedx.com/emedx/diagnosis_information/shoulder_disorder

http://www.radiologyassistant.nl/en/p4963d77684ef7/shoulder-mr-bankart-lesions.html

https://www.hss.edu/condition-list_labral-tears-glenoid-labrum.asp

https://www.shoulderdoc.co.uk/section/896

http://www.howardluksmd.com/education/common-injuries/shoulder-labrum-labral-tears-is-surgery-necessary/

http://emedicine.medscape.com/article/401990-overview~

http://www.orthopaedics.com.sg/conditions/shoulder-pain/glenoid-labrum-tear

https://en.wikipedia.org/wiki/SLAP_tear

Depositos de cálcio na espadua

http://www.scoi.com/patient-resources/patient-education/calcium-deposits-shoulder

http://www.webmd.com/a-to-z-guides/calcium-deposits-and-tendinitis-calcific-tendinitis-topic-overview

https://www.shoulderdoc.co.uk/section/10

http://emedicine.medscape.com/article/1267908-treatment

http://www.medicinenet.com/calcific_bursitis/article.htm

http://www.houstonmethodist.org/orthopedics/where-does-it-hurt/shoulder/calcific-tendonitis/

https://en.wikipedia.org/wiki/Calcific_tendinitis

http://kneeandshoulderclinic.com.au/shoulders/surgical-conditions/calcific-tendonitis/

Dor no ombro

A dor no ombro pode dever-se a pressão da coifa dos rotadores ou a lesões dar ar ticulações gleno-umeral ou acromioclavicular. Todavia a maior parte das vezes provem de lesões do pescoço  

Espadua alada

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684151/

https://www.shoulderdoc.co.uk/section/492

http://www.physio-pedia.com/Winged_scapula

http://gait.aidi.udel.edu/res695/homepage/pd_ortho/educate/clincase/sprengle.htm

https://en.wikipedia.org/wiki/Winged_scapula

Espadua deslizante

http://www.orthogate.org/patient-education/shoulder/snapping-scapula-syndrome

https://en.wikipedia.org/wiki/Snapping_scapula_syndrome

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3711706/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445084/

https://www.shoulderdoc.co.uk/article/684

http://www.humpalphysicaltherapy.com/Injuries-Conditions/Shoulder/Research-Articles/Diagnosis-and-Treatment-of-Snapping-Scapula-Syndrome/a~2058/article.html

http://www.houstonmethodist.org/orthopedics/where-does-it-hurt/shoulder/snapping-scapula-syndrome/

http://orthodoc.aaos.org/provencher/snapping%20scapula%20-%20diagnosis%20and%20treatment.pdf

http://www.thesportsphysiotherapist.com/snapping-scapula-syndrome-scapulothoracic-bursitis-assessment-and-management/

http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=daafe3c4-da64-4f80-b01c-6a50ce1a290d

Exame da espadua

http://emedicine.medscape.com/article/1909254-technique

http://patient.info/doctor/shoulder-examination

http://www.aafp.org/afp/2000/0515/p3079.html

http://geekymedics.com/shoulder-examination/

http://www.osceskills.com/e-learning/subjects/shoulder-examination/

http://stanfordmedicine25.stanford.edu/the25/shoulder.html~

http://orthosurg.ucsf.edu/oti/patient-care/divisions/sports-medicine/physical-examination-info/shoulder-physical-examination/

https://www.shoulderdoc.co.uk/section/497

Osteolise da clavícula distal

http://www.shoulderpaininfo.com/shoulderACOs

http://emedicine.medscape.com/article/1262297-overview            

http://radiopaedia.org/articles/distal-clavicular-erosion-differential

https://www.nyboneandjoint.com/articles/ac-joint-osteolysis-weight-lifters-shoulder/

http://radiopaedia.org/articles/osteolysis-of-distal-clavicle-mnemonic

Ruptura do bicipete no ombro

http://emedicine.medscape.com/article/327119-overview

https://www.shoulderdoc.co.uk/article/704

http://patient.info/doctor/tendon-rupture

http://www.howardluksmd.com/orthopedic-social-media/biceps-tears-require-surgery/

http://www.coreperformance.com/knowledge/injury-pain/the-complete-guide-to-torn-biceps.html

http://www.houstonmethodist.org/orthopedics/where-does-it-hurt/shoulder/biceps-rupture

/

Separaçao do ombro

http://www.mayoclinic.org/diseases-conditions/separated-shoulder/basics/definition/con-20029283

o the ligaments that hold your collarbone to your shoulder blade. In a mild separated shoulder, the ligaments may just be stretched. In severe injuries, ligaments may be completely ruptured.

In most people, a separated shoulder doesn't usually require surgery. Instead, conservative treatment — such as rest, ice and pain relievers — is often enough to relieve the pain. Most

http://orthoinfo.aaos.org/topic.cfm?topic=a00033

http://orthoinfo.aaos.org/topic.cfm?topic=a00033

http://www.learningradiology.com/archives05/COW%20138-AC%20Separation/acseparationcorrect.htm

http://www.sportsinjuryclinic.net/sport-injuries/shoulder-pain/ac-joint-sprain

http://radiopaedia.org/articles/acromioclavicular-inju

http://thesteadmanclinic.com/shoulder_acseperation/treat.asp

http://thesteadmanclinic.com/shoulder_acseperation/overview.

http://www.cedars-sinai.edu/Patients/Programs-and-Services/Orthopaedic-Center/Clinical-Programs/Sports-Medicine/Acromioclavicular-AC-Joint-Separation.aspx

 http://www.emedx.com/emedx/diagnosis_information/shoulder_disorders/shoulder_separation_outline.htm

http://www.wheelessonline.com/ortho/ac_joint_separation

https://en.wikipedia.org/wiki/Separated_shoulder

Sindroma de impacto do ombro ( impingement)

http://www.orthogate.org/patient-education/shoulder/impingement-syndrome

Impingement syndrome occurs when the rotator cuff tendons rub against the roof of the shoulder, the acromion.

http://orthoinfo.aaos.org/topic.cfm?topic=A00032&return_link=0

The acromion "impinges" on the rotator cuff and bursa.

http://emedicine.medscape.com/article/92974-overview

http://www.webmd.com/osteoarthritis/guide/impingement-syndrome

https://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-impingement-syndrome-of-the-shoulder

In most parts of the body, the bones are surrounded by muscles. In the shoulder region, however, the muscle and tendons are surrounded by bone. If one taps on the top of the shoulder, bone can be felt immediately under the skin. Underneath that bone is the rotator cuff, a group of muscles and tendons that we use to lift the arm up overhead. The rotator cuff is sandwiched between the arm bone and the top of the shoulder (acromion). This unique arrangement of muscle and tendon between bone contributes to the development of impingement syndrome (shoulder bursitis, rotator cuff tendinitis).

When an injury to the rotator cuff occurs, it responds by swelling much the way an ankle does when it is sprained. However, because the rotator cuff is surrounded by bone, its swelling causes a number of events to occur. The pressure within the tendon increases, resulting in compression (squeezing) and loss of blood flow in the capillaries (small blood vessels).

When the blood flow is reduced, the tendon tissue begins to fray much like a rope. As the tissue swells, it results in the classic features of a pain like a toothache.

http://www.nhs.uk/Conditions/impingement-syndrome/Pages/Impingement-syndrome.aspx

http://www.medicinenet.com/impingement_syndrome/article.htm

http://physioworks.com.au/injuries-conditions-1/rotator-cuff-impingement

http://www.sportsinjuryclinic.net/sport-injuries/shoulder-pain/impingement-syndrome-shoulder

http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=1793961e-c552-4367-b3fb-61a1467b7930

Tendinite do bicipete

http://orthoinfo.aaos.org/topic.cfm?topic=a0002

6

http://emedicine.medscape.com/article/96521-treatment

http://www.aafp.org/afp/2009/0901/p470.html

https://www.shoulderdoc.co.uk/article/722

https://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-biceps-tendon-injuries

http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=6737f4e9-e8ec-43fe-b0b9-01e86354dcea

http://patient.info/doctor/biceps-tendonitis

http://www.houstonmethodist.org/orthopedics/where-does-it-hurt/shoulder/biceps-tendonitis/

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