Upper limb injuries often result from repetitive strain, trauma, or degenerative changes. They commonly present with pain, weakness, or functional limitation. 🩺 A structured approach - history ➝ examination ➝ targeted imaging ➝ stepwise management - is essential for diagnosis and care.


Injury Type	Cause	Diagnosis (Clinical Features)	Investigations	Management
Rotator Cuff Tear 🎯	Acute trauma (fall, lifting heavy object) Degenerative tear in older adults Repetitive overhead activity (sports, labour)	Shoulder pain, worse at night 🌙 Weakness in abduction & external rotation Painful arc, reduced overhead function	X-ray ➝ rule out fracture/arthritis Ultrasound/MRI ➝ confirm tear, assess extent	Conservative: Rest, NSAIDs, physio, steroid injection Surgical repair for large/full tears (esp. young/active)
Tennis Elbow (Lateral Epicondylitis) 🎾	Overuse of wrist extensors Repetitive gripping/typing/manual labour	Lateral elbow pain & tenderness Pain ↑ with resisted wrist extension	Clinical diagnosis Ultrasound: tendon thickening MRI if persistent/refractory	Activity modification, NSAIDs, physio (eccentric loading) Steroid or PRP injection if refractory Surgery in severe/chronic cases
Golfer’s Elbow (Medial Epicondylitis) ⛳	Repetitive wrist flexion/pronation Seen in golfers, pitchers, manual work	Medial elbow pain Pain ↑ with resisted wrist flexion	Clinical diagnosis Ultrasound/MRI in severe cases	Rest, NSAIDs, physio (stretch & strengthen) Steroid/PRP injections if refractory Surgery for resistant cases
Carpal Tunnel Syndrome ⌨️	Repetitive wrist flexion (typing, assembly work) Pregnancy, RA, diabetes increase risk	Numbness/tingling in thumb, index, middle fingers Night symptoms 🌙 Weak thumb abduction (thenar wasting if chronic)	Nerve conduction studies (gold standard) Ultrasound/MRI ➝ median nerve compression	Wrist splinting (esp. at night) Steroid injections, NSAIDs Surgical decompression if severe/persistent
De Quervain’s Tenosynovitis 👍	Repetitive thumb/wrist motion Common in new mothers (“mother’s wrist”)	Pain/swelling at thumb base Positive Finkelstein’s test	Clinical diagnosis US: thickened tendon sheath	Thumb spica splint + NSAIDs Steroid injection for persistent pain Surgical release if refractory
Trigger Finger ☝️	Repetitive gripping Linked to diabetes & RA	Locking/catching finger Tenderness at A1 pulley Severe ➝ fixed flexion deformity	Clinical diagnosis US: thickened tendon sheath	Splinting, NSAIDs Steroid injection for moderate cases Surgical release if refractory

💡 Teaching Pearl: Always start with conservative management for soft tissue injuries. Surgery is reserved for persistent pain, functional limitation, or complete tears. Physiotherapy is central to recovery 🏋️.

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Upper limb Soft Tissue Injuries

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