Specialists

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Partial Thickness Rotator Cuff Tears: Treatment

Partial thickness rotator cuff tears can result from intrinsic cuff degeneration and tendinopathy absent an injury or impingement. The lack of uniformity of collagen bundles and the paucity of vascular supply contributes to weakness, especially along the articular aspect of the rotator cuff. These degenerative tears often exit the articular surface and can be well […]

Diagnostic Imaging

It is essential that the initial evaluation of the painful shoulder include quality plain radiographs. The standard radiographs should include a true anterior-posterior view with the shoulder in the internal and neutral position, an axillary view, and the outlet (supraspinatus) view described by Neer and Poppen, which is used to evaluate and classify acromial morphology […]

Clinical Evaluation-Physical Examination

After completing a detailed history, a focused examination can be undertaken. It is critical to compare extremities as the unaffected shoulder can serve as a “normal” template to which one can compare. One should survey for atrophy or asymmetry, especially in the supra and infraspinatus fossae. Long-standing rotator cuff tears are often accompanied by significant, […]

Tear of the Tendon of the Triceps

Falling on the hand when the arm is flexed or forceful throwing can cause a rupture in the tendon of the triceps. Weightlifting with very heavy weights can also cause this injury. Most tricep tears are partial and are most commonly located at the insertion of the olecranon (the tip of the elbow); occasionally, however, […]

Partial Tears

In a cuff with smooth coverings of synovial and bursal tissue, the severity of a partial tear can be classified as follows:

1. Minimal superficial bursal or synovial irritation, or slight capsular fraying with a partial tear less than 1 cm (0.4 in) in size.

2. Actual fraying and failure of some rotator cuff fibers […]

Subscapularis Tendon Rupture

SYMPTOMS

There is acute or gradual onset of exercise-induced pain and weakness on internal rotation with the shoulder in a neutral position, and difficulty in reaching the lower back with the hand.

AETIOLOGY

The onset can be dramatic and relate to an anterior shoulder dislocation caused by heavy tackling, for example in rugby.

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Rotator Cuff Rupture

SYMPTOMS

There is usually exercise-related pain and weakness of the shoulder on abduction and in overhead activities. The player may relate that ‘something snapped’ in the shoulder. In many partial ruptures, the initial symptom is secondary impingement or muscle atrophy and weakness.

AETIOLOGY

The onset can be dramatic, with complete loss of abduction […]

Triceps Tendon Rupture

SYMPTOMS

There is acute onset of pain and bleeding around the triceps, tendor insection at the olecranon of the elbow, and loss of extension power.

AETIOLOGY

This is an injury occurring from an excessive eccentric contraction or direct impact to the elbow, often affecting players in contact sports. Occasionally an avulsion fracture may […]