Bois Bernard Private Hospital
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Secretariat: 03 21 79 26 36
This page is dedicated to Healthcare Professionals
The shoulder / the General Practitioner
Shoulder pathologies are multiple and can sometimes seem complex. Apart from a few rare diagnoses, shoulder pathologies remain easy to diagnose. They are summarized around 4 pathologies in 90% of cases. These pathologies are:
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- Pathologies of the rotator cuff (tendinous ruptures, tendonitis, subacromial impingement)
- Omarthrosis (Centered or Eccentric)
- Instabilities (with or without dislocation)
- Acromioclavicular arthropathies
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A clinical examination of the shoulder only takes 3 minutes. It makes it possible to approach the diagnosis in most cases and to guide the prescription of additional examinations.
This examination naturally follows an interrogation during which the medical history, the circumstances of occurrence, the duration of evolution, the location and the nature of the pain will be recorded. Particularly important is the terrain on which shoulder pathology occurs. In young subjects under 25 years of age, we will first think of an instability pathology, in middle-aged female subjects, capsulitis and calcifications of the shoulder will be particularly considered. In subjects over 50 years old, it is the pathology of the rotator cuff which will be by far in the first place. The socio-professional context is important. it is necessary to identify the arduousness of the patient's work, but also the notion of sinistrosis which can settle around a pathology of the shoulder...
A well-conducted interview helps to understand the socio-professional context of the patient, and the appearance of disorders (pain, functional deficit). In addition to this questioning, a very rapid clinical clinical examination most often makes it possible to approach the diagnosis in 90% of cases.
This approach makes it possible to choose the best imaging prescription to aim for the most precise diagnosis possible. The surgeon will perform the same approach to choose the best treatment, which will most often be medical.
Surgery is often the last option.
Imaging confirms the diagnosis or corrects it.
the images and their interpretation are not always faithful to the real diagnosis... You have to know how to choose the best imaging.
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Plain x-rays are essential.
Shoulder ultrasound.
The simple CT scan of the shoulder is of no interest.
Arthro-scanner or Burso-scanner?
MRI or arthro-MRI?
An electro-myography examination?
A scan?
Rehabilitation is essential.
It fits into the concept of
Enhanced Recovery After Surgery (RAAC) .
Sometimes this rehabilitation is necessary before surgery.
Sometimes, an excellent rehabilitation can compensate for a surgical gesture.
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Hospitalization in a Rehabilitation Center is EXCEPTIONALLY necessary.
The anesthesia is completed by an Inter-Scalenic Block (BIS) . When performing this BIS, a micro-catheter is placed in contact with the nerve roots.
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This catheter is connected to an electronic diffuser.
This device allows you to return home the same day of your intervention.
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This device is managed by your nurse at your home