PAINFUL ARC SYNDROME

PAINFUL ARC SYNDROME

Q. 1 Painful arc syndrome is seen in all of the following conditions, EXCEPT:

 A Complete tear of supraspinatus

 B

Fracture of greater tuberosity

 C

Subacromial bursitis

 D

Supraspinatus tendinitis

Q. 1

Painful arc syndrome is seen in all of the following conditions, EXCEPT:

 A

Complete tear of supraspinatus

 B

Fracture of greater tuberosity

 C

Subacromial bursitis

 D

Supraspinatus tendinitis

Ans. A

Explanation:

Conditions associated with painful arc syndrome are subacromial bursitis, supraspinatus tendinitis, in incomplete tear or calcified deposit in supraspinatus tendon and in incomplete fracture of greater tuberosity of humerus.

 
In painful arc syndrome pain appears between 40 and 120 degree of shoulder abduction because in this position supraspinatus tendon is impinged against the undersurface of acromion and head of humerus.
Rest of the movements are painless.
 
Causes of impingement syndrome are:
  • Complete or partial rupture of rotator cuff
  • Supraspinatus tendonitis
  • Calcific deposits
  • Subacromial bursitis
  • Subdeltoid bursitis
  • Periarthritis
  • Bicipital tenosynovitis
  • Fracture of greater trochanter
Ref: Essentials of Orthopaedics for Physiotherapist  By Ebneza page 231.

Q. 2 Causes of painful arc syndrome is/ are ‑

 A

Supraspinatus tendinitis

 B

Subacromial bursitis

 C

Fracture of greater tuberosity

 D

All the above

Ans. D

Explanation:

Ans. is ‘d’ i.e., All the above

Painful Arc syndrome

  • This is a clinical syndrome in which there is pain in the shoulder and upper arm during the mid range of glenohumeral abduction. Following are the common causes :
  1. Minor tears of the supraspinatus tendon
  2. Supraspinatus tendinitis
  3. Calcification of supraspinatus tendon
  4. Subacromial bursitis
  5. Fracture of the greater tuberosity
  • In all these conditions, the space between the upper – end of the humerus and the acrominon gets compromised, so that during mid – abduction the tendon of the rotator – cuff gets nipped between the greater tuberosity and acrominon.
  • X- ray of the shoulder may show calcific deposit, or a fracture of the greater tuberosity or acromion. o Treatment consists of ultrasonics to the tender point and anti- inflammatory drugs.
  • Some cases need an injection of hydrocortisone in the subacromial space or excision of the anterior, often prominent part of the acromion.

Q. 3 Painful arc syndrome is caused by impingement of ‑

 A Sub acromial bursa

 B

Sub deltoid bursa

 C

Rotator cuff tendon

 D

Biceps tendon

Ans. C

Explanation:

Ans. is ‘c’ i.e., Rotator cuff tendon

Painful arc syndrome

Pain in the shoulder and upper arm during the mid-range of glenohumeral abduction.
Causes – supraspinatus tendon tear or tendinitis, subacromial bursitis, fracture of the greater tuberosity.
The space between the upper end of the humerus and the acromion gets compromised so that during mid abduction the tendon of rotator cuff gets nipped between the greater tuberosity and acromion.



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