Rotator cuff tear: Difference between revisions
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# | ==Background== | ||
*Shoulder pain after acute trauma, chronic injury, or acute extension of chronic impingement | |||
*Tears due to chronic impingement in pts >40yr accounts for majority | |||
#Injury: 90% chronic arms overhead | |||
==Diagnosis== | |||
#result of extreme overuse in young adults (e.g. pitchers) or minor trauma in older adults | |||
#sudden "pop" while lifting overhead | |||
#lateral pain | |||
#worse at night | |||
#abduct arm pain after 20deg | |||
#relief of pain w/ lido inject | |||
#(pain free weakness = full tear) | |||
===Physical=== | |||
#loss of active BUT NOT passive ROM (due to pain) | |||
#positive impingement signs | |||
#weakness with drop arm test | |||
==Treatment== | |||
#Acute --> sling, PT, ortho f/u | |||
#Chronic --> PT, ortho | |||
#Next: MRI, surgery for younger pts with big tear, rehab | |||
#PT: arm dangle at side, circle 5-10wt | |||
==See Also== | |||
*[[Shoulder (Acute - Trauma)]] | |||
[[Category:Ortho]] | |||
Revision as of 03:57, 22 February 2012
Background
- Shoulder pain after acute trauma, chronic injury, or acute extension of chronic impingement
- Tears due to chronic impingement in pts >40yr accounts for majority
- Injury: 90% chronic arms overhead
Diagnosis
- result of extreme overuse in young adults (e.g. pitchers) or minor trauma in older adults
- sudden "pop" while lifting overhead
- lateral pain
- worse at night
- abduct arm pain after 20deg
- relief of pain w/ lido inject
- (pain free weakness = full tear)
Physical
- loss of active BUT NOT passive ROM (due to pain)
- positive impingement signs
- weakness with drop arm test
Treatment
- Acute --> sling, PT, ortho f/u
- Chronic --> PT, ortho
- Next: MRI, surgery for younger pts with big tear, rehab
- PT: arm dangle at side, circle 5-10wt