Rotator cuff tear
11,601views
00:00 / 00:00
Videos
Notes
Rotator cuff tear
Musculoskeletal system
Pediatric musculoskeletal conditions
Radial head subluxation (Nursemaid elbow)
Developmental dysplasia of the hip
Legg-Calve-Perthes disease
Slipped capital femoral epiphysis
Transient synovitis
Osgood-Schlatter disease (traction apophysitis)
Musculoskeletal injuries and trauma
Rotator cuff tear
Dislocated shoulder
Radial head subluxation (Nursemaid elbow)
Winged scapula
Thoracic outlet syndrome
Carpal tunnel syndrome
Ulnar claw
Erb-Duchenne palsy
Klumpke paralysis
Iliotibial band syndrome
Unhappy triad
Anterior cruciate ligament injury
Patellar tendon rupture
Meniscus tear
Patellofemoral pain syndrome
Sprained ankle
Achilles tendon rupture
Spondylolysis
Spondylolisthesis
Degenerative disc disease
Spinal disc herniation
Sciatica
Compartment syndrome
Rhabdomyolysis
Bone disorders
Osteogenesis imperfecta
Craniosynostosis
Pectus excavatum
Arthrogryposis
Genu valgum
Genu varum
Pigeon toe
Flat feet
Club foot
Cleidocranial dysplasia
Achondroplasia
Osteomyelitis
Bone tumors
Osteochondroma
Chondrosarcoma
Osteoporosis
Osteomalacia and rickets
Osteopetrosis
Paget disease of bone
Osteosclerosis
Lordosis, kyphosis, and scoliosis
Joint disorders
Osteoarthritis
Spondylosis
Spinal stenosis
Rheumatoid arthritis
Juvenile idiopathic arthritis
Gout
Calcium pyrophosphate deposition disease (pseudogout)
Psoriatic arthritis
Ankylosing spondylitis
Reactive arthritis
Spondylitis
Septic arthritis
Bursitis
Baker cyst
Muscular disorders
Muscular dystrophy
Polymyositis
Dermatomyositis
Inclusion body myopathy
Polymyalgia rheumatica
Fibromyalgia
Rhabdomyosarcoma
Neuromuscular junction disorders
Myasthenia gravis
Lambert-Eaton myasthenic syndrome
Other autoimmune disorders
Sjogren syndrome
Systemic lupus erythematosus
Mixed connective tissue disease
Antiphospholipid syndrome
Raynaud phenomenon
Scleroderma
Limited systemic sclerosis (CREST syndrome)
Musculoskeletal system pathology review
Back pain: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Seronegative and septic arthritis: Pathology review
Gout and pseudogout: Pathology review
Systemic lupus erythematosus (SLE): Pathology review
Scleroderma: Pathology review
Sjogren syndrome: Pathology review
Bone disorders: Pathology review
Bone tumors: Pathology review
Myalgias and myositis: Pathology review
Neuromuscular junction disorders: Pathology review
Muscular dystrophies and mitochondrial myopathies: Pathology review
Assessments
Rotator cuff tear
Flashcards
0 / 22 complete
USMLE® Step 1 questions
0 / 2 complete
USMLE® Step 2 questions
0 / 2 complete
High Yield Notes
5 pages
Flashcards
Rotator cuff tear
of complete
Questions
USMLE® Step 1 style questions USMLE
of complete
USMLE® Step 2 style questions USMLE
of complete
Image reproduced from Radiopedia
Which of the following physical examination maneuvers is most likely to yield a positive test, given this patient’s clinical findings?
Memory Anchors and Partner Content
External Links
Transcript
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.
Summary
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.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "MR Imaging of Rotator Cuff Injury: What the Clinician Needs to Know" RadioGraphics (2006)
- "Delineation of diagnostic criteria and a rehabilitation program for rotator cuff injuries" The American Journal of Sports Medicine (1982)
- "Compressive cryotherapy versus ice—a prospective, randomized study on postoperative pain in patients undergoing arthroscopic rotator cuff repair or subacromial decompression" Journal of Shoulder and Elbow Surgery (2015)
Copyright © 2023 Elsevier, except certain content provided by third parties
Cookies are used by this site.
USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.
