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poliartrita studenti

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    PERIARTRITA SCAPULOMUMERALA

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    DEFINITIE:

    sindrom clinic caracterizat prin durere,

    redoare articulara si impotenta functionala

    determinat de procese patologice localizate lanivelul umarului si care afecteaza structurile

    periarticulare: ligamente, capsula articulara,

    tendoane, bursa si muschi.

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    CLASIFICARE:

    1. Umar simplu dureros

    2. Umar dureros acut3. Umar mixt

    4. Umar blocat

    5. Umar pseudoparalitic

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    CAUZE:

    1. INTRINSECI:

    - Artrite reumatismale

    - Artrite infectioase- Artrite posttraumatice

    - Artropatii degenerative

    - Neurogene

    - Neoplazice

    - Afectiuni periarticulare

    2. EXTRINSECI

    -Neuropatii C5-C6

    -Sindroame fibromialgice-Sdr Pancoast-Tobias

    -Sdr Parsonage-Turner

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    CAZ CLINIC

    ANAMNEZA:

    1. Istoric:

    - Boli reumatismale (inflamatorii/degenerative)- Comorbiditati nereumatismale

    - Traumatisme, CVM

    2. Simptome:- Durerea (caracter, localizare)

    - Redoarea (prezenta/absenta)

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    ANATOMIE FUNCTIONALA

    EXAMEN CLINIC

    ARTICULATII SINOVIALE:

    1.Glenohumerala

    2.Acromioclaviculara3.Sternoclaviculara

    ARTICULATII FUNCTIONALE:1.Scapulotoracica

    2.Subacromiodeltoidiana (suprahumerala)

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    EXAMEN CLINIC

    1. INPECTIE

    2. PALPARE

    3. MOBILITATE

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    INSPECTIA

    Anterior Posterior Lateral

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    INSPECTIA

    - simetria reperelor osoase

    - simetria contururilor musculare

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    PALPAREA

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    PALPAREA

    ARTICULATII:

    -sternoclaviculara

    -acromioclaviculara

    INSERTII CAPSULOLOIGAMENTARE

    -supraspinos- biceps

    - deltoid

    -varful coracoidei

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    PALPAREAHIPOTROFIA/TUMEFACTIA/CONTRACTURA MUSCULARA

    -Trapez

    -Angular

    -Deltoid

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    MOBILITATEA

    -Flexia (antepulsia)

    - Extensia (retropulsia)

    -Abductia

    -Adductia

    -Rotatia interna

    -Rotatia externa

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    MOBILITATEA

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    RADIOGRAFIA

    Tumefactia partilor moi

    Osteocondensarea rebordului glenoidian/

    culisei bicipitale Deformarea, descentrarea capului humeral

    Pensarea spatiului artic. acromioclaviculare

    Chisturi subcondrale

    Osteofite

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    ECOGRAFIA

    - insertiile, structura tendoanelor

    -procese inflamatorii la nivelul burselor (bursite)

    - ruptura coifului rotatorilor

    -Capsula (ingrosata/retractata)

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    DIAGNOSTIC

    - tendinite : supraspinos, infraspinos, biceps,

    -Bursite

    -sindrom de impingement

    -sdr de ruptura a coifului rotatorilor

    -capsulita retractila

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