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CONTACT US
Reuben Gobezie, M.D.
Director, Cleveland Shoulder Institute University Hospitals of Cleveland
Fellowship Director, Cleveland Akron Shoulder & Elbow Fellowship (CASE)
Head, Cartilage Transplant Center of Cleveland
Phone Numbers
Appointments: (216) 844-7200
Office Number: (216) 844-7093
FAX Number: (216) 844-5970
Email: Reuben.Gobezie@UHhospitals.org
Office Locations
UHHS Chagrin Highlands Medical Center
3909 Orange Place
Orange Village, OH 44122
County: Cuyahoga-East
Phone Number: (216) 844-7093
Fax Number: (216) 844-5970
Directions To Our Office
University Suburban Health Center
1611 S. Green Road
South Euclid, OH 44121
Phone Number: (216) 844-7093
Fax Number: (216) 844-5970
Directions To Our Office
University Hospitals
Westlake Campus
960 Clague Road
Westlake, OH
Directions To Our Office
UHHS Bedford Medical Center
44 Blaine Ave
Cleveland, OH 44146
Phone Number:(216) 844-7093
Directions To Our Office
8819 Commons Boulevard
Twinsburg, OH 44087
Phone Number:(216) 844-7093
Directions To Our Office
University Hospitals Mentor
9000 Mentor Ave
Mentor, OH
Directions To Our Office
UH Richmond Medical Center
27100 Chardon Rd
Richmond Hts, OH 44143
Phone: (216) 844-7093
Fax: (216) 844-5970
Directions To Our Office
UH Concord Health Center
7500 Auburn Rd
Concord, OH 44077
Directions To Our Office
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Diagnosis
How is atraumatic shoulder
instability diagnosed?
A thorough history and physical examination are the keys to the diagnosis
and treatment of MDI (Multidirectional Instability). The classic findings
are:
- a history of generalized laxity.
- no history of a forceful dislocation event.
- a history of recurrent episodes of instability.
The patient's history may reveal a recent injury, an obvious dislocation, or a change in sport or
training that has led to instability in a previously healthy shoulder.
A general examination of joint mobility is very helpful. By moving
the arm around in several positions, the doctor can evaluate full
shoulder motion. Multidirectional laxity may be present in both shoulders
even though only one may be bothersome to the patient. A patient
with MDI has an increase in glenohumeral translation (shoulder joint
movement) in multiple directions, and symptoms can be recreated in
one or more directions. More than 2 cm of movement during the
sulcus test suggests the presence of MDI. The diagnosis
of MDI should be based on this result combined with the evaluation
of overall shoulder motion and the symptoms triggered when the doctor
moves the arm in several directions.
Further evaluation may include some form of visual study of the shoulder.
- X-rays are always obtained, primarily to rule out any
associated injuries that would require treatment. Occasionally
the images reveal a congenital (present since birth) abnormality
that may be contributing to the instability.
- An MRI (Magnetic Resonance Image) can reveal other sources
of the shoulder pain that may require more than a rehabilitation
program alone for successful treatment.
- An arthroscopy allows the surgeon to visually
evaluate the structures of the glenohumeral joint using a tiny
fiberoptic instrument. Other related injuries may be revealed
since increased movement and repetitive trauma in the joint can
lead to injuries of the labrum and partial thickness
rotator cuff tears. With arthroscopy, these injuries can
be treated at the time of the examination, and the patient may
go on to achieve a pain free shoulder with a rehabilitation program.
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