Rotator cuff: acute injuries

What are the variables that impact the management of rotator cuff injuries?

Rotator cuff pathology comprises a wide range of different problems. At one end of the spectrum is a patient with acute rotator impingement. These patients may have an anatomically normal rotator cuff and have symptoms which have been provoked by an acute bout of activity. In this situation, the problem will generally settle with a short period of rest.

At the other end of the spectrum are patients who have an acute injury to their shoulder, and present with significant pain, weakness and a loss of function. These patients may have an acute, full-thickness rotator cuff injury. This generally requires surgical management to regain satisfactory function (and pain-relief).

In between these extremes is a range of very varied pathology including more chronic cuff impingement, partial thickness tears or tendinopathy and full-thickness rotator cuff tears. These tears can be of varying sizes, orientations and can affect different tendons. The wide range of pathology is one reason why there is very little good-quality evidence to guide treatment decisions.

Objectives of this course:

• Understand classic symptoms and signs of rotator cuff pathology on history and examination.
• Gain knowledge of the appropriate imaging investigations for a patient presenting with a rotator cuff injury.
• Be aware of the variables that can impact decision making with regards to the management of a rotator cuff injury.

Acknowledgements

This content was created by Dr Helen Joyce Fulcher MBChB, DipPaed, PGCertHSc(Sports Med), and updated by Dr Grace Lee, FRNZCGP, MBCHB, BSc, DipTravMed.