RotatorCuff Disorders

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Rotator Cuff

• Disorders

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Anterior shoulder Pain

• Traumatic Ant. Subluxation
• AC joint Pathology
• Suprascapular Nerve Inj.
• Chronic Impingement Syndrome

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Diagnosis

• Clinical
• X-ray
• Arthrography
• Ultrasonography
• MRI
• Arthroscopy

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Incidence Tear Area
Complete Tear 5-15 Partial Tear 30-40
Study in Cadaver
lt60 yr 6 gt60 yr 30

• Bursal Side 9
• Joint Side 11
• Intertendinous 7

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Study In Living Subjects

• Painful Shoulder In Clinical Assessment 21
• Asymptomatic Shoulder in MRI 20
• Asymptomatic Shoulder in Arthrography 40

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Yamanaka 1994

• 1th Arthrographic Study gt60 yr
• 40/67 Partial Tear

2 th Arthrography Healed 4 Worsen
21 Complete Tear 11
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Clinical Types

• Asymptomatic
• Posterior Capsular Tightness
• SubAC Abrasion
• RC Arthropathy

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Sign Symptom

• Stiffness
• Pain
• Instability
• Roughness

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Sign Symptom

• Stiffness Int rot in Abd.
• Pain Reach up the back
• Instability Cross Body Add.
• Roughness Flexion

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Sign Symptom

• Stiffness
• Pain Resisted Muscle Action
• Instability
• Roughness

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Sign Symptom

• Stiffness
• Pain
• Instability Ant instabilitygt SubSC
• Roughness Superior inst.

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Sign Symptom

• Stiffness
• Pain
• Instability
• Roughness Crepitation (SubSC abresion
  RC arthropathy)

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X-ray

• Atrophy and Sclerosis of Great Tuberosity.
• Cystic Change in the Neck of Humerus.
• Irregularity in Lateral of Acromion.
• Ossification of Coraco-acromial ligament.
• Decreased Acromio-Humeral Distance.

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Arthrography

• Most Reliable Method to Detecting a Complete
  Tear of Rotator Cuff
• Neer

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Leakage to subacromial Bursa
Normal
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Ultrasonography
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MRI
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Oblique Coronal
T1
T2
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Thank you