scholarly journals Predicting the outcome of conservative treatment with physiotherapy in adults with shoulder pain associated with partial-thickness rotator cuff tears – a prognostic model development study

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Cordula Braun ◽  
Nigel C. Hanchard ◽  
Helen H. Handoll ◽  
Andreas Betthäuser
Keyword(s):  
Rotator Cuff ◽  
Conservative Treatment ◽  
Shoulder Pain ◽  
Prognostic Model ◽  
Model Development ◽  
Rotator Cuff Tears ◽  
Development Study ◽  
Partial Thickness

scholarly journals Rotator cuff unloading versus loading exercise program in the conservative treatment of patients with rotator cuff tear: protocol of a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040820
Author(s):  
Larissa Pechincha Ribeiro ◽  
Ann Cools ◽  
Paula Rezende Camargo
Keyword(s):  
Rotator Cuff ◽  
Conservative Treatment ◽  
Shoulder Pain ◽  
Rotator Cuff Tear ◽  
Social Life ◽  
Rotator Cuff Tears ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Cuff Tear ◽  
Shoulder Range Of Motion

IntroductionAtraumatic and degenerative rotator cuff tears are common in individuals over 55 years of age. This condition can have a high impact on social life and is associated with chronic pain, weakness and dysfunction of the upper limb. There is evidence that conservative approaches should be the first treatment option. Conservative treatment usually addresses a variety of therapeutic behaviours without providing scientific arguments for the choice and progression of exercises.ObjectiveTo compare the effects of two different exercise programmes based on the load of the rotator cuff on a population with shoulder pain and rotator cuff tears.Methods and analysisThis is a controlled, randomised, blinded clinical trial. Seventy-eight individuals with shoulder pain and presence of atraumatic and degenerative rotator cuff tear will participate and will be randomly distributed between two groups. The primary outcome will be quality of life (The Western Ontario Rotator Cuff Index), and secondary outcomes will include pain, function (Disabilities of the Arm, Shoulder and Hand), fear avoidance beliefs (Fear Avoidance Beliefs Questionnaire-Brazil), kinesiophobia (Tampa Scale), Pain Catastrophizing Scale, muscle strength of abductors, external and internal rotators of the shoulder, range of motion of arm elevation and patient satisfaction. The treatment will be performed for 12 weeks (2 x/week) acording to the selected group (Rotator Cuff Unloading x Rotator Cuff Loading Exercise Programme).Ethics and disseminationThe study protocol was approved by the Institutional Review Board. The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberNCT03962231.

scholarly journals ROLE AND CORELATION OF ULTRASONOGRAPHY AND MAGNETIC RESONANCE IMAGING IN EVALUATION OF ROTATOR CUFF IN PATIENTS WITH SHOULDER PAIN

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Niti More ◽  
R P Bansal ◽  
Mukesh Kumar Sharma ◽  
Bijendra Kumar Meena ◽  
Abhishek Gupta
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Age Groups ◽  
Rotator Cuff Tears ◽  
Joint Effusion ◽  
Full Thickness ◽  
Mri Findings ◽  
Partial Thickness ◽  
Labral Tears ◽  
Sensitivity Specificity

Background: Shoulder pain is one of the most common musculoskeletal complain encountered in general practice with an estimated point prevalence of 6.9 to 26% in the general population. The aim of the study was to determine the accuracy of ultrasonography in detecting rotator cuff tears taking MRI findings as the standard. Available literature related to the present study was reviewed and salient features of each pathology discussed. Methods: This observational, prospective study was carried out in the Department of Radiodiagnosis, National Institute Of Medical Sciences & Research, Jaipur, Rajasthan. A total of 80 patients from all age groups with symptomatology related to rotator cuff of the shoulder joint, on the basis of inclusion criteria, were examined by USG and MRI from a period of January 2019 to June 2020. Results: USG had good sensitivity (82 to 93%), specificity (92 to 97%), PPV (85 to 87%), NPV (91 to 98%) and accuracy (90 to 96%) as compared MRI for diagnosing supraspinatus lesions. The sensitivity and accuracy of USG for detecting full thickness tears was better than the same for partial thickness tears and tendinosis. Conclusion: In our study, USG examination had excellent sensitivity, specificity and accuracy as compared MRI for diagnosing full thickness rotator cuff tears. It was also fairly accurate in detecting partial thickness tears and tendinosis. It was comparable to MRI in diagnosing and quantifying joint effusion and acromioclavicular degenerative changes. USG scored over MRI in diagnosing calcific tendinosis while some findings, such as labral tears, were only detected by MRI. Keywords: MRI, USG, Shoulder pain.

Partial-Thickness Rotator Cuff Tear by Itself Does Not Cause Shoulder Pain or Muscle Weakness in Baseball Players

2019 ◽  
Vol 47 (14) ◽  
pp. 3476-3482
Author(s):  
Teruhisa Mihata ◽  
Rei Morikura ◽  
Akihiko Hasegawa ◽  
Kunimoto Fukunishi ◽  
Takeshi Kawakami ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Rotator Cuff Tear ◽  
Muscle Weakness ◽  
Rotator Cuff Tears ◽  
Tendon Tear ◽  
Baseball Players ◽  
Cuff Tear ◽  
Partial Thickness ◽  
Tendon Tears

Background: Partial-thickness rotator cuff tears are common shoulder injuries in baseball players. For some tears, the symptoms can be relieved through physical therapy or debridement without rotator cuff repair. Purpose: To assess whether partial-thickness rotator cuff tear by itself causes shoulder pain and muscle weakness in baseball players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We studied 87 university baseball players (age, 19.5 ± 0.8 years; baseball career, 11.5 ± 1.6 years). All data were obtained during a full-participation annual medical check in 1 team. Rotator cuff tendons were examined ultrasonographically and allocated to 4 groups: (1) no tear, (2) supraspinatus tendon tear, (3) infraspinatus tendon tear, and (4) both supraspinatus and infraspinatus tendon tears. Current shoulder pain and shoulder muscle strength (dominant/nondominant) in abduction, external rotation, and internal rotation were compared by using chi-square and t tests. All players could play baseball with or without shoulder pain in this study. Results: Of the 87 players, 41 (47%) had articular-sided partial-thickness rotator cuff tears diagnosed on ultrasonography; the remaining 46 athletes were tear-free. Of the 41 affected patients, 19 had tears in the supraspinatus, 13 in the infraspinatus, and 9 in both the supraspinatus and infraspinatus tendons. Tear depth (mean ± SD) was 4.6 ± 2.3 mm in the supraspinatus and 6.2 ± 3.6 mm in the infraspinatus. Neither the rate of shoulder pain nor muscle strength differed significantly among the 4 groups ( P = .96 and P = .15-.70, respectively). Conclusion: Articular-sided partial-thickness rotator cuff tear—by itself—did not cause shoulder pain and muscle weakness in university baseball players. Most so-called articular-sided partial-thickness rotator cuff tears may not be pathologic tendon tears.

scholarly journals Partial-thickness Rotator Cuff Tear Itself Did Not Cause Shoulder Pain Or Muscle Weakness In Baseball Players

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0043
Author(s):  
Teruhisa Mihata ◽  
Rei Morikura ◽  
Kunimoto Fukunishi ◽  
Yukitaka Fujisawa ◽  
Takeshi Kawakami ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Shoulder Pain ◽  
Muscle Weakness ◽  
Return To Play ◽  
Rotator Cuff Tears ◽  
Tendon Tear ◽  
Baseball Players ◽  
Partial Thickness ◽  
Significant Difference

Objectives: Rotator cuff tears are common shoulder injuries in baseball players. In some severe tears (i.e. through more than 50% of the cuff’s thickness), conservative treatment does not work well, and surgical treatment is sometimes chosen in an effort to ensure return to play. In contrast, some partial thickness rotator cuff tears do not cause shoulder symptoms, even during throwing motion. The objective of this study was to assess whether partial thickness rotator cuff tears cause shoulder pain and muscle weakness in baseball players. Methods: We studied 87 university baseball players (age: 19.5±0.8 years; baseball career: 11.5±1.6 years). Rotator cuff tendons were ultrasonographically examined (Fig 1), then divided into 4 groups; (1) no tear, (2) supraspinatus tendon tear, (3) infraspinatus tendon tear, (4) both supraspinatus and infraspinatus tendons tear. Current shoulder pain and shoulder muscle strength (Dominant/Non-dominant) in abduction, external rotation, and internal rotation were compared using Chi square test and t-test. Results: Forty-one (47%) players were diagnosed with articular-sided partial-thickness rotator cuff tears using ultrasonography. Nineteen tears were in the supraspinatus, 13 in the infraspinatus, and 9 in both the supraspinatus and the infraspinatus. Tear depth was 4.6±2.3 mm in the supraspinatus and 6.2±3.6 mm in the infraspinatus. There was no significant difference in rate of shoulder pain (p=0.96) and muscle strength among four groups (p=0.15 - 0.70). Conclusion: In this study, articular-sided partial-thickness rotator cuff tears did not cause shoulder pain and muscle weakness in university baseball players. Most of articular-sided partial-thickness rotator cuff tears are tears of the superior capsule but not the rotator cuff tendons, because the superior capsule is attached in the articular half of the greater tuberosity. Therefore, most so-called articular-sided partial-thickness rotator cuff tears may not be pathological tendon tear.

scholarly journals Can ultrasound suffice for triaging patients requiring surgical correction of rotator cuff tears—a comparative evaluation of ultrasound and magnetic resonance imaging

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Aniket Agarwal ◽  
Kavita Vani ◽  
Anurag Batta ◽  
Kavita Verma ◽  
Shishir Chumber
Keyword(s):  
Rotator Cuff ◽  
Biceps Tendon ◽  
Surgical Correction ◽  
Statistical Testing ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Partial Thickness ◽  
Linear Probe ◽  
Significant Difference ◽  
Sensitivity Specificity

Abstract Background Objectives: To comparatively evaluate the role of ultrasound and MRI in rotator cuff and biceps tendon pathologies and to establish ultrasound as a consistently reproducible, quick and accurate primary investigation modality sufficient to triage patients requiring surgical correction of full thickness rotator cuff tears. Methods: Fifty patients, clinically suspected to have rotator cuff and/or biceps tendon pathologies, with no contraindications to MRI, were evaluated by US and MRI, in a prospective cross-sectional observational study. US was done with high-frequency linear probe, and MRI was done on a 1.5-T scanner using T1 oblique sagittal, proton density (PD)/T2 fat-suppressed (FS) oblique sagittal, T1 axial, PD/T2 FS axial, T1 oblique coronal, T2 oblique coronal and PD FS oblique coronal sequences. Statistical testing was conducted with the statistical package for the social science system version SPSS 17.0. The sensitivity, specificity, PPV, NPV and accuracy were also calculated to analyze the diagnostic accuracy of US findings correlating with MRI findings. A p value less than 0.05 was taken to indicate a significant difference. Results Mean age was 45 years; 74% patients were males; 77% females and 60% males had tears. Majority of patients with rotator cuff tears were in the sixth decade of life. The frequency of tears was higher among older patients. Fourteen percent of patients had full thickness tears while 64% had partial thickness tears. US was comparable to MRI for detection of full thickness tears with overall sensitivity, specificity, PPV and accuracy of 93.8%, 100%, 100% and 98.2%, respectively (p value < 0.001). For partial thickness tears, US had overall sensitivity, specificity, PPV and accuracy of 75.6%, 82.6%, 89.5% and 78%, respectively (p value < 0.001), as compared to MRI. Subacromial-subdeltoid bursal effusion and long head of biceps tendon sheath effusion were common associated, though, non-specific findings. Conclusion Ultrasound findings in our study were found to be in significant correlation with findings on MRI in detection of rotator cuff tears. US was equivalent to MRI in detection of full thickness tears and fairly accurate for partial thickness tears. Therefore, US should be considered as the first line of investigation for rotator cuff pathologies.

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