Presentation and diagnosis of rotator cuff tears
- Stephen M Simons, MD, FACSM
Stephen M Simons, MD, FACSM
- South Bend Sports Medicine Fellowship
- J Bryan Dixon, MD
J Bryan Dixon, MD
- Clinical Assistant Professor of Family Medicine
- Michigan State University College of Human Medicine
- Medical Director
- United States Olympic Education Center
- David Kruse, MD
David Kruse, MD
- Primary Care Sports Medicine
- Orthopaedic Specialty Institute
- Section Editor
- Karl B Fields, MD
Karl B Fields, MD
- Editor-in-Chief — Primary Care Sports Medicine (Adolescents and Adults)
- Section Editor — Biomechanics, Rehabilitation, and Recovery; Sports-Related Injuries; Symptom Assessment and Physical Examination
- Professor of Family Medicine and Sports Medicine
- University of North Carolina at Chapel Hill
- Deputy Editors
- Jonathan Grayzel, MD, FAAEM
Jonathan Grayzel, MD, FAAEM
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Assistant Professor of Emergency Medicine
- University of Massachusetts Medical School
- Susanna I Lee, MD, PhD
Susanna I Lee, MD, PhD
- Deputy Editor — Radiology
- Associate Professor of Radiology
- Harvard Medical School
- Massachusetts General Hospital
Shoulder pain is a common presenting complaint to primary care offices and sports medicine clinics. Estimates of the prevalence of shoulder pain range from 16 to 34 percent in the general population [1,2]. Rotator cuff pathology is the most common condition of the shoulder for which patients seek treatment . Estimates published in 2004 by the United States Agency for Health Care Research and Quality and United States Department of Health and Human Services show rotator cuff problems accounted for more than 4.5 million clinician visits and approximately 40,000 surgeries .
Despite this burden on patients and health care resources, there remains significant controversy regarding the etiology of rotator cuff injuries, the role of rotator cuff tears in generating shoulder pain, and the ability of commonly accepted clinical tests to diagnose rotor cuff tears.
The etiology, presentation, and diagnosis of rotator cuff tears will be reviewed here. The treatment of rotator cuff tears, rotator cuff tendinopathy, the shoulder examination, and the general management of patients with shoulder pain are discussed separately. (See "Management of rotator cuff tears" and "Rotator cuff tendinopathy" and "Physical examination of the shoulder" and "Evaluation of the patient with shoulder complaints".)
ANATOMY AND BIOMECHANICS
The anatomy and biomechanics of the shoulder generally are discussed separately (figure 1A-C). (See "Evaluation of the patient with shoulder complaints", section on 'Anatomy and biomechanics'.) The biomechanics of the rotator cuff specifically are discussed elsewhere. (See "Rotator cuff tendinopathy", section on 'Clinical anatomy' and "Rotator cuff tendinopathy", section on 'Basic biomechanics'.)
MECHANISM OF INJURY
The development of underlying rotator cuff tendinopathy is discussed elsewhere. (See "Rotator cuff tendinopathy".)
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