Rotator Cuff Tear

Question 1

What is the common tendon torn in a RCT?

Answer 1

Supraspinatus

Question 2

What is the clinical presentation of a RCT?

Answer 2

1. Just like impingement but more severe
2. Night pain is common
3. Catching sensation
   *will need an MRI between impingement and RCT

Question 3

What will you find during a PE on a patient with RCT?

Answer 3

Inspection: atrophy
ROM: decreased actively in most patients, may be decreased passively as well, but not as severe
*Patient may be unable to abduct the arm even 90 degrees and will be unable to maintain the arm abducted if examiner moves it

Question 4

What is the best diagnostic testing for a RCT?

Answer 4

1. MRI can show
   *partial vs full thickness
   *large vs small
   *amount of retraction
   *amount of atrophy

Question 5

What are some of the adverse outcomes of RCT?

Answer 5

1. Progressive weaning and worsening of condition without surgery
2. Joint degeneration with larger, untreated tears

Question 6

What is the medical treatment for RCT?

Answer 6

1. NSAIDS
2. Therapy/strengthening
3. Lifestyle modifications
4. Cortisone injections (3-4 a year)

Question 7

What is the surgical treatment for a RCT?

Answer 7

1. Indicate for a full thickness tears
   *those with a partial thickness tear fare more favorably long-term
2. If the RCT is acute attempt to have surgery within 6 weeks
3. If RCT is chronic try conservative tx first

Question 8

When would you refer a patient with RCT?

Answer 8

1. Refer patient with RCT or impingement whom have failed 6 weeks of conservative treatment