Rotator Cuff Tears: Clinical, Radiographic, and US Findings1

Department of Radiology, North Shore University Hospital, Great Neck, NY 11021, USA.
Radiographics (Impact Factor: 2.6). 11/2005; 25(6):1591-607. DOI: 10.1148/rg.256045203
Source: PubMed


Rotator cuff tears are a common cause of shoulder pain. Clinical and radiographic findings can suggest the presence of a rotator cuff tear. The most sensitive clinical findings are impingement and the "arc of pain" sign. Radiographic findings are usually normal in the acute setting, although the "active abduction" view may show decreased acromiohumeral distance. In more chronic cases, an outlet view may show decreased opacity and decreased size of the supraspinatus muscle due to atrophy. In late cases, the humeral head may become subluxated superiorly, and secondary degenerative arthritis of the glenohumeral joint may ensue. Ultrasonography (US), with over 90% sensitivity and specificity, can help confirm the diagnosis in clinically or radiographically equivocal cases. US can also reveal the presence of other abnormalities that may mimic rotator cuff tear at clinical examination, including tendinosis, calcific tendinitis, subacromial subdeltoid bursitis, greater tuberosity fracture, and adhesive capsulitis.

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    • "All patients underwent shoulder sonography in a seated position in a wheelchair. Both shoulders were examined in all patients using the scanning techniques described above.3,11,12 In patients with limited motion in the hemiplegic shoulder joint, affected shoulder pain, or cognitive dysfunction, the shoulder girdle was examined placed in position similar to that used in the dynamic examination; however, passive movement was induced for these patients with the help of an assistant. "
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    • "A variable alteration will be produced in the subacromial space as a result, with chronic compression of the cuff and of the underlying synovial structures (bursae). A series of inflammatory and degenerative events may be associated at this point.27 "
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    • "A number of studies suggest that a diagnostic imaging test should be associated with the physical exploration [13,14]. US is a non-invasive method with a diagnostic precision [15] comparable to that of MRI for both, subacromial bursitis [13] and the different degrees of rotator cuff alteration [14,16]. Given the lack of clarity in clinical diagnosis, the existence of lesions in asymptomatic shoulders [17,18] and the scarce effectiveness of treatments [19,20], some authors consider that there may be another structure causing pain and dysfunction [21-23]. "
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