Rotator cuff tears often present with shoulder pain, weakness, and loss of range of motion. The long head of the biceps tendon is also often included in rotator cuff pathology. The rotator cuff tendons include supraspinatus, infraspinatus, teres minor, and subscapularis ( Figures 1 and and2). 1 The annual cost of treating shoulder pain was $7 billion in the year 2000 in the United States. Rotator cuff tears are the leading cause of shoulder pain and shoulder-related disability accounting for 4.5 million physician visits in the United States annually. It is useful in diagnosis of rotator cuff tears, impingement syndrome, and biceps pathology. This protocol is thorough yet time-efficient for a busy clinical practice.
We also discuss the clinical implications and limitations of the physical examination maneuvers described in our protocol.
The protocol can be typically completed in 15 minutes. This protocol can be used to isolate the specific rotator cuff tendon involved. Among the many tests for rotator cuff disorders that have been described, we chose ones that have been more thoroughly assessed for sensitivity and specificity. Our protocol includes range of motion testing using a goniometer, strength testing using a dynamometer, and select special tests. To fill this void, we present a physical examination protocol developed on the basis of review of prior literature and our clinical experience from dedicated shoulder practices. We are not aware of a clinical review article that presents a structured physical examination protocol of the rotator cuff for the interested clinician.
A careful history and structured physical examination are often sufficient for diagnosing rotator cuff disorders.
0 kommentar(er)
