4: Rotator Cuff Tear Flashcards
What is the most common site of rotator cuff tendon tears?
Supraspinatus
What muscle tendon is the rarest tendon to tear in a rotator cuff tear?
Teres minor
What is the most common cause of rotator cuff tears over the age of 40?
Age-related degeneration
What is the most common cause of rotator cuff tendinopathy?
Subacromial impingement
Subacromial impingement typically does not progress to RC tear in the general population (TRUE/FALSE)?
TRUE
A 50 year old male complains of left shoulder pain of three months duration that he noticed when he awoke one morning. He works as an electrician for the past 35 years. He denies any precipitating event or previous history of shoulder problems. Raising his hand over his head makes his shoulder pain worse. He denies chest pain, difficulty breathing, abdominal symptoms, or problems with digestion. There was pain in the anterolateral aspect of the left shoulder at 110 degrees of shoulder flexion. Strength of rotator cuff muscles were 5/5. Reflexes, sensation, and motor power were intact. What is the likely diagnosis?
A. Osteoarthritis
B. Adhesive Capsulitis
C. Impingement Syndrome
D. Supraspinatus Tear
C. Impingement Syndrome
What is the most common cause of shoulder pain over the age of 35?
Rotator cuff injury
A rotator cuff tear is a tear of the ____
Tendon
What are causes of rotator cuff tears?
Age-related degeneration (#1)
Subacromial impingement
Tension overload
Major trauma
(Rotator cuff tendinopathy)
All rotator cuff tendinopathies progress to a RC tear (TRUE/FALSE)?
FALSE
What are common causes of rotator cuff tears in ATHLETIC populations UNDER 35 years of age?
Subacromial impingement and tension overload
How do tears of the supraspinatus tendon progress?
Start at the anterior edge of the tendon and progress posteriorly
A massive tear of the supraspinatus tendon normally affects atleast two adjacent tendons (TRUE/FALSE)?
TRUE
A massive tear of the supraspinatus tendon can couple with tears of what other adjacent tendons?
Infraspinatus and/or subscapularis tendons
The majority of rotator cuff tears heal on their own (TRUE/FALSE)?
FALSE
The majority of rotator cuff tears get progressively greater in size over time (TRUE/FALSE)?
TRUE
Most tears occur on the ____ side of a tendon?
Articular (undersurface)
What are reasons for why a rotator cuff doesn’t heal?
Constant traction on SSp tendon with arm hanging
Poor environment for healing
Poor vascular supply
Synovial fluid disrupts clotting and healing
A massive tear must include atleast two adjacent tendons (TRUE/FALSE)?
TRUE
What is the common chief complaint in a patient with a rotator cuff tear?
Pain and/or weakness
What is the common age for a patient with a rotator cuff tear?
50+ (can be 40+)
A patient over 40 with a rotator cuff tear will have what common cause of rotator cuff tear?
Age-related degeneration (No one event or cause)
A patient under 40 with a rotator cuff tear will have what common cause of rotator cuff tear?
Impingement, tension, or trauma (high intensity overhead athletics)
How can you differentiate between a localized small tear and a massive tear of the rotator cuff?
- small tear: weakness of injured muscle (4/5 or weaker)
- massive tear: 2 adjacent mm test weak on testing OR MRI
A 4/5 on manual muscle testing is weak enough to indicate a possible RC tear (TRUE/FALSE)?
TRUE
What is the drop arm test?
Eccentric loading of the supraspinatus to determine a rotator cuff tear
A drop arm test has a high (Sensitivity/Specificity) and low (Sensitivity/Specificity)?
Specificity, Sensitivity
What is SNout?
If a sensitive test is NEGATIVE, it rules OUT a condition
What is SPin?
If a specific test is POSITIVE, it rules IN a condition
An impingement test is often positive in ____ tears?
Supraspinatus
A positive drop arm test is highly specific for a rotator cuff tear (TRUE/FALSE)?
TRUE
A negative drop arm test rules out a rotator cuff tear (TRUE/FALSE)?
FALSE
A positive impingement test assures the diagnosis of a rotator cuff tear (TRUE/FALSE)?
FALSE
(low specificity)
A negative impingement test helps rule out a RC tear (TRUE/FALSE)
TRUE
(moderate sensitivity)
A positive impingement test has low (Sensitivity/Specificity) and moderate (Sensitivity/Specificity)?
Specificity, Sensitivity
What is Sensitivity?
The percentage of patients WITH the condition that have a positive test (true positive)
What is Specificity?
The percentage of patients WITHOUT the condition that have a negative test (true negative)
What is the goal of rotator cuff tear treatment?
Decrease pain and increase function
What is performed for treatment of a rotator cuff tear in regards to the GH joint?
Mobilization ONLY (no manipulation on GH)
Surgical outcomes for a rotator cuff tear are best if performed early (TRUE/FALSE)?
TRUE
