User:Saltrabook/Clinical diagnostic guidelines/Ocupational musculoskeletal diseases/Shoulder Tendinitis

Definition

 * Tendinitis is an inflammation of a tendon or tendon attachment
 * Tendinitis in the shoulder can occur in the following tendons: The supraspinatus tendon, The infraspinatus, The subscapularis, Teres minor tendon, Biceps tendon (the long head)
 * The rotatorcuff is made ​​up of four muscles (supraspinatus, infraspinatus, subscapularis, and teres minor) that coordinates and stabilizes the shoulder movements. In addition, the biceps, which also helps to stabilize the shoulder.
 * Rotator cuff syndrome is the term for inflammation of one or more of rotatorcuffens tendons, most commonly the supraspinatus tendon. By supraspinatusseneaffektion are often seen simultaneously subacromial bursitis. Clinically, it may be difficult to distinguish between tendinitis in supraspinatus- and biceps tendon

Epidemiology

 * Shoulder pain occurs in 7-34% of the general population and in approximately 20% of people over 70 years. In studies of exposed groups found the prevalence of rotator cuff syndrome between 4 and 31% in control groups found prevalence between 1 and 9%, , It is not in these epidemiological studies to distinguish between rotator cuff syndrome and bursitis subachromiale
 * Shoulder pain is generally due to tendinitis (75% and about 4 of 5 occur in the supraspinatus tendon), bursitis (15%) or frozen shoulder (10%). A combination of conditions is frequent

Risk Factors

 * There is evidence that the combination of strenuous and repetitive movements of the arms and work with arms raised above shoulder height leads to an increased risk of skuldertendinitis
 * Typical business: Slaughterhouse workers, heavier industrial assembly tasks. Building Painters, electricians, insulators, hairdressers and other industries where part of working going on with her arms raised above shoulder level
 * Clinic and diagnostics: Reference is made to the sections on rotator cuff syndrome and chronic bursitis
 * Clinic and diagnostics: Reference is made to the sections on rotator cuff syndrome and chronic bursitis
 * Clinic and diagnostics: Reference is made to the sections on rotator cuff syndrome and chronic bursitis

Causation

 * Symptoms of the disease are expected to act directly related to the period of execution of the shoulder-straining tasks. Epidemiological studies have shown that the greater the proportion of the day when you work with arms lifted, the greater the risk of developing skuldertendinitis. The exact limit for this is not known, but the case is recognized as work-related if the proportion is half of the working day or more. Studies of blood flow in supraspinatusmusklen which compromised by various degrees of elevation, supports the findings of the epidemiological studies
 * Significantly strenuous and repetitive work are also shown to be a risk factor. Again it is known the exact duration
 * Competing risk factors: Sports (tennis, swimming, handball). Former shoulder trauma. Anatomical relationship is deemed to be important, for example. a curved akromion or osteophytes

Vocational guidance and prevention

 * 50% of patients with shoulder problems in general practice still have problems after 6 months and 40% after 12 months2
 * If the patient's work involves the risk factors mentioned above, it must be determined how the patient can avoid these. It may be necessary relocation, if necessary. rehabilitation. On the whole, it will be the patient's functional that determines whether the patient can continue normal work
 * The extent of the known shoulder stressors should preferably be reduced, which can be achieved for example. by job rotation, to avoid chord work and the use of assistive

Review

 * Changes in the shoulder rotator tendons (rotator cuff syndrome / skuldertendinitis, tendinitis musculi articulatio humeri / impingementsyndrom) is recognized as an occupational disease by repetitive and strenuous shoulder movements combined with an assessment of the position of the arm with the load
 * Changes in the biceps (biceps tendinitis, tendinitis caput longum musculus bicipitis brachii) is recognized as a result of static lifting of the upper arm to about 60 degrees or more
 * There must have been relevant shoulder-straining work every day for at least half of the working day (3-4 hours) and long time (monthly)