Welcome to The UW Shoulder Site @ uwshoulder.com
Please note that information on this site was NOT authored by Dr. Frederic A Matsen III and has not been proofread or intended for general public use. Information was intended for internal use only and is a compilation for random notes and resources.
If you are looking for medical information about the treatment of shoulders, please visit shoulderarthritis.blogspot.com for an index of the many blog entries by Dr. Frederick A Matsen III.
Notes for MA
Thank you so much for helping the Shoulder and Elbow team. We appreciate you and need your help in seeing patients.
If Connie, Steve or Alex is around - they can answer most questions that will come up.
After rooming a patient, please pull up Centricity so that we can view films after the patient returns to the room. This helps us out tremendously.
All packets must have (with patient labels):
* Note - Some patients will come in with the old 2 page New Patient Information Form filled out - these patients must also have a Simple Shoulder Test or Simple Elbow Test for all affected shoulder and elbows (patients often come in with more than one joint problem)
New Patients (never been seen by Shoulder and Elbow team or not seen in past 3 years)
Please take vitals and height and weight. Make sure that new patients have filled out a New Shoulder Patient Information Form
* Note - Some patients will come in with the old 2 page New Patient Information Form filled out - these patients must also fill out a Simple Shoulder Test and/or Simple Elbow Test for all affected shoulder and elbows (patients often come in with more than one joint problem). Please make sure they fill out both sides of each 2 sided forms.
New Patients must have an X-ray done - See Below.
2 Week Post Op Patients
Two week post op patients are here to get their incision sites inspected as well as for a quick check up on how they are doing.
X-rays are rarely needed at this visit. Generally, only fracture repairs really need films at this visit.
Please remove steri-strips if on patient and clean the incision site with three batadine swabs (unless allergic to betadine or iodine). Then remove staples and/or suture (look for suture tails at both ends of incisions).
If the incision site looks worrisome, get Doc or PA to take a look at it prior to steri-striping it.
Apply a little tincture of benzoin to both edges of incision and apply steri-strips over incision.
Inform patient that they should keep this area clean and dry for 24hours and then can take regular showers. They should remove steri-strips if they are still on after 7 days.
6 Week Post Op Patients
We often need x-rays at this visit
Patients with the following need an x-ray:
|1. Total Shoulder Arthroplasty (TSA)||- Arthritis Series|
|2. Hemi Arthroplasty||- Arthritis Series|
|3. Ream and Run||- Arthritis Series|
|4. Total Elbow Arthroplasty||- Matsen Elbow Series|
|5. Fracture repair||- Arthritis Series|
The following patients do not need an x-ray:
You should ask about others
3 Month Post Op Patients
Most of these patients do not need an x-ray.
If they did not have a 6 week Post Op appointment, they will need those X-rays taken during this visit.
Please take vital and height and weight. Have patient fill out health questionnaire from their Preop Packet, Simple Shoulder Test and/or Simple Elbow Test, etc. Place Yellow packet outside door to let us know they are there.
Please print out last clinic note done by us so that we can review the patient's history and reason for surgery.
X rays are very important to us. After rooming the patient, please pull up Centricity so that we can view films after the patient returns to the room. Have all female patients remove their bras and put on a short sleeved robe on prior to going to x-ray.
All patients need to have a current x-ray for evaluation purposes. Patients with MRIs only, outside films and out dated x-rays taken here (more than 6 months) - need new films done by our techs. All new patients must have an x-ray.
Please have all females remove their bras and put on a gown prior to calling x-ray to get the patient. Bras often have metal in them that show up in the shoulder field and cause delays as patients must be refilmed.
X-Rays by Complaint
Rotator Cuff Tear (first visit only)
(Axillary, Grashey, and Template of Shoulder)
Clear History of:
Hx of dislocation
"shoulder keeps coming out of joint"
If not clear - Arthritis Series
Instability Series Anything about elbow 4 view Elbow True fracture of Humerus AP and Lat of Humerus AC separation AC Series Bilat with and without weights SC separation Serendipity View
AP SC Joint
When in doubt Arthritis series
(Axillary, Grashey, and Template of Shoulder)
X-Rays by Series
Most patients need a three view arthritis series (Axillary, Grashey, and Template of Shoulder).
Indication: Arthritis, Rotator Cuff Tear (first visit only), Pain
If patients are complaining about instability, you can order an instability series. This can be confusing since many patients are not sure how to describe their shoulder symptoms and often say they are unstable due to arthritis or pain. Unless it is clear that they are unstable or had a dislocation, go ahead and order an arthritis series.
Indication: Instability, Bankart lesion, Hx of dislocation, "shoulder keeps coming out of joint"
Matsen Elbow Series - 4 view
Elbow complaints need a 4 view of the elbow
Indication: Anything about elbow
AP and Lat of Humerus
Fractured humeri need an AP and Lateral of Humerus
Indication: True fracture of Humerus
AC Series Bilat with and without weights
This is for AC separations.
Indication: AC separation
If a patient has pain or instability in sternum area they need an Serendipity View of the SC joint. You may also need to do an AC series to assess the Clavicle.
Indications: SC separation
When in doubt - order an arthritis series.
Patient Education Handouts
There should be some color handouts of some of our shoulder procedures.
Total Shoulder Arthroplasty
Ream and Run Arthroplasty (aka Hemi-arthroplasty)
Delta Reverse Shoulder Arthroplasty
Total Elbow Arthroplasty
Rotator Cuff Repair
Bankart Repair (Shoulder instability repair)