Cuff Disease

Question 1

Two types of cuff disease

Answer 1

impingement

tear

Question 2

define cuff disease impingement

Answer 2

tendons of the rotator cuff are compressed in the subacromial space during movement

Question 3

presentation of cuff disease impingement

Answer 3

pain in acromion

pain can radiate to deltoid and upper arm

Question 4

diagnosis of cuff disease impingement

Answer 4

Hawkin’s-Kennedy, Scarf and Jobes test

painful arc at 60-120 degrees of abduction due to supraspinatus tendon passing subacromial space (BUZZWORD)

Question 5

conservative management of cuff disease impingement

Answer 5

rest
analgesics
physiotherapy
steroid injections (3)

Question 6

surgical management for cuff disease impingement

Answer 6

arthroscopic or open subacromial decompression (last resort)

Question 7

cause of cuff tear

Answer 7

degeneration

injury

Question 8

what muscle do tears usually involve?

Answer 8

supraspinatus

Question 9

presentation of cuff tear

Answer 9

grey hair=cuff tear
weakness
dull achy pain
tenderness over shoulder around glenohumeral and AC joint
difficulty sleeping on affected side, reaching over head and lifting

Question 10

diagnosis of cuff tear

Answer 10

Gerbert’s and painful arc with rotator cuff weakness (initiation of abduction- supraspinatus)
GOLD STANDARD is USS
MRI gives more detail e.g. wasting of muscle

Question 11

conservative management of cuff tear

Answer 11

rest
analgesia
sling
physio
steroids and LA injections

Question 12

surgical management of cuff tear

Answer 12

arthroscopic or open repair of rotator cuff or subacromial decompression