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Lordosis, kyphosis, and scoliosis
Osteomalacia and rickets
Paget disease of bone
Calcium pyrophosphate deposition disease (pseudogout)
Juvenile idiopathic arthritis
Inclusion body myopathy
Degenerative disc disease
Spinal disc herniation
Achilles tendon rupture
Anterior cruciate ligament injury
Iliotibial band syndrome
Patellar tendon rupture
Patellofemoral pain syndrome
Carpal tunnel syndrome
Thoracic outlet syndrome
Radial head subluxation (Nursemaid elbow)
Rotator cuff tear
Lambert-Eaton myasthenic syndrome
Limited systemic sclerosis (CREST syndrome)
Mixed connective tissue disease
Systemic lupus erythematosus
Developmental dysplasia of the hip
Osgood-Schlatter disease (traction apophysitis)
Slipped capital femoral epiphysis
Back pain: Pathology review
Bone disorders: Pathology review
Bone tumors: Pathology review
Gout and pseudogout: Pathology review
Muscular dystrophies and mitochondrial myopathies: Pathology review
Myalgias and myositis: Pathology review
Neuromuscular junction disorders: Pathology review
Pediatric musculoskeletal disorders: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Scleroderma: Pathology review
Seronegative and septic arthritis: Pathology review
Sjogren syndrome: Pathology review
Systemic lupus erythematosus (SLE): Pathology review
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Patient Success Story: Torn Rotator Cuff Surgery
The rotator cuff refers to a group of four muscles and their tendons, which help to stabilize the shoulder when it’s moving particularly during rotational motion. So, a rotator cuff tear is when one or more of the tendons of the muscles of the rotator cuff are torn.
The shoulder is a complex of bones, ligaments, muscles and their tendons that all work together to connect the upper limb to the chest, allowing necessary movement and providing stability.
The round head of the humerus fits and rotates inside the shallow glenoid cavity of the scapula. Just above the glenoid cavity, the scapula extends two bony processes; the acromion and the coracoid processes which serve as attachment for ligaments and muscle tendons.
The ligaments of the capsule of the glenohumeral joint hold the head of the humerus inside the glenoid cavity. The coracoacromial ligament forms an arch between the coracoid process and the acromion and it prevents the head of the humerus from upward dislocation.
In addition to these ligaments, the shoulder is supported by the four rotator cuff muscles, also called the SITS muscles, for Supraspinatus, Infraspinatus, Teres minor, and Subscapularis.
The SITS muscles form a cuff that surrounds the head of the humerus to make it stable and help it move, specifically in abduction, as well as internal and external rotation. Below the acromion lies the acromial bursa, which is a small sac filled with rubbery synovial fluid, that provides lubrication and prevents the rotator cuff tendons, especially the supraspinatus tendon, from rubbing against the acromion as the joint moves.
A rotator cuff tear occurs when one or more tendons of the SITS muscles - Supraspinatus, Infraspinatus, Teres minor, and Subscapularis - of the rotator cuff are torn. Acute tears happen when the tendons are violently stretched, like falling on an outstretched arm. Chronic tears result from cumulative wear and tear of the tendon, and it usually occurs in the elderly.
The cuff is responsible for stabilizing the glenohumeral joint, abducting, externally rotating, and internally rotating the humerus. When shoulder trauma occurs, these functions can be compromised. The diagnosis is clinical, mainly based on pain and weakness, specifically with abduction or rotation, and can be confirmed with an MRI. Treatment involves rest, ice, and pain control, but if it fails, surgery may be needed.
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