Rotator cuff injury

Last reviewed: 7 Sep 2022
Last updated: 05 Apr 2018

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • shoulder pain
  • shoulder weakness
  • loss of active ROM
  • pain and weakness on external rotation test
  • pain and weakness on empty-can test
More key diagnostic factors

Other diagnostic factors

  • deltoid pain
  • night pain
  • pain and weakness on lift-off test
  • pain and weakness on belly-press test
  • pain on Neer impingement test
  • pain on Hawkins impingement test
  • adhesive capsulitis
Other diagnostic factors

Risk factors

  • age >60 years
  • hx of repetitive overhead movement
  • hx of superior labral tears
  • shoulder injury
More risk factors

Diagnostic investigations

1st investigations to order

  • x-rays
More 1st investigations to order

Investigations to consider

  • diagnostic injection
  • MRI
  • ultrasound
  • magnetic resonance arthrography
  • CT arthrography
  • CT scan
More investigations to consider

Treatment algorithm

ACUTE

acute small tear

acute medium/large/massive reparable tear

acute irreparable tear

ONGOING

chronic symptomatic tear

Contributors

Authors

Robert J. Gionfriddo, DO

Assistant Director

Department of Medicine

Hartford Hospital

Hartford

CT

Disclosures

RJG declares that he has no competing interests.

Jason Jacob, MD

Assistant Director

Department of Medicine

Hartford Hospital

Hartford

CT

Disclosures

JJ declares that he has no competing interests.

Acknowledgements

Dr Robert J. Gionfriddo and Dr Jason Jacob would like to gratefully acknowledge Dr Daniel J. Solomon and Dr Michael G. Clarke, previous contributors to this monograph. DJS serves as a speaker/course instructor for Arthrex Inc. and Pacific Medical Inc. and has received honoraria from both companies. MGC declares that he has no competing interests.

Peer reviewers

Matthew T. Provencher, MD

Assistant Director

Orthopaedic Shoulder and Sports Surgery

Naval Medical Center San Diego

San Diego

CA

Disclosures

MTP declares that he has no competing interests.

Radhakant Pandey, FRCS, McH(orth)

Consultant in Trauma and Orthopaedics

Department of Trauma and Orthopaedics

Leicester Royal Infirmary

Leicester

UK

Disclosures

RP declares that he has no competing interests.

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