Rotator Cuff Disease (From Required Medscape Readings)

Question 1

In a shoulder contrast injection, the presence of ___________________ indicates a rotator cuff tear.

Answer 1

contrast in the subacromial bursa

Question 2

Name the two hypothesis behind the pathology of RC tears:

Answer 2

The extrinsic hypothesis
In this theory, the lesion results mainly from repeated impingement of the rotator cuff tendon against different structures of the glenohumeral joint.

The intrinsic hypothesis
In this theory, the lesions result from progressive age-related degeneration of the tendon.

Question 3

What are the three stages of Neers impinegment?

Answer 3

Neer described impingement lesions in the following 3 progressive stages:

In stage 1, edema and hemorrhage result from excessive overhead use and are observed in patients younger than 25 years.

In stage 2, fibrosis and tendinitis affect the bursa and the cuff following repeated episodes of mechanical inflammation in patients aged 25-40 years.

In stage 3, bone spurs and incomplete and complete tears of the rotator cuff and long head of the biceps tendon are found almost exclusively in patients older than 40 years.

Question 4

What are the three impingement syndromes that Neers argued lead to RC tears?

Answer 4

The anterointernal impingement syndrome- coracohumeral interval
The posterosuperior impingement syndrome-posterosuperior edge of the glenoid cavity
The anterosuperior impingement syndrome- coracoacromial arch

Question 5

Shoulder pain is the ____ most common cause of musculoskeletal disorder after low back pain (LBP) and cervical pain.

Answer 5

third