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Rotator Cuff Tears

 Syn. Supraspinatous tendon tear , Rotator cuff pathology , Rotator cuff rupture

Signs & Symptoms

 Shoulder pain
Note: Develop over the lateral deltoid. should not allow the presence or absence of pain to play too significant a role in diagnosis
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate] Epocrates [ https://online.epocrates.com/diseases/58633/Rotator-cuff-injury/History-Exam]
Overhead activity
Note: May present at a younger age
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate]
Exacerbating at night
Note: When the patients lies on the shoulder
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate] Epocrates [ https://online.epocrates.com/diseases/58633/Rotator-cuff-injury/History-Exam]
Exacerbating with Overhead activity
Note: May present at a younger age
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate] Epocrates [ https://online.epocrates.com/diseases/58633/Rotator-cuff-injury/History-Exam]

Physical Examination

 Active painful arc test
Note: Pain that occurs between 60 and 120 degrees of active abduction
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate]
Weakness on lift-off test
Note: Evaluates the patient's ability to lift the hand away from the small of the back as the examiner applies resistance. The examiner must ensure the patient uses the shoulder and arm rather than wrist and fingers to perform this task
Ref: Epocrates [ https://online.epocrates.com/diseases/58633/Rotator-cuff-injury/History-Exam]
Painful ROM
Note: Pain that occurs between 60 and 120 degrees of active abduction
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate]

Lab / Serology

Imagin Study

 Proliferative spur formation of the acromion or acromioclavicular joint
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate]
Full thickness tears of the infraspinatus
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate]
Full thickness tears of the supraspinatus
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate]

Complication

Risk Factors

 Elder
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate]
Obesity
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate]
Smoking
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate]

Cause

 Moving the shoulder too fast and with too much force
Ref: Uptodate [ Patient education: Rotator cuff injury, uptodate]
Falling on the shoulder
Ref: Uptodate [ Patient education: Rotator cuff injury, uptodate]
Trauma
Ref: Uptodate [ Presentation and diagnosis of rotator cuff tears, Uptodate]

Other