Rotator Cuff Tears

Rotator cuff tears, which are common among the elderly, can be classified as acute or chronic and full or partial thickness. They cause significant upper extremity dysfunction. Pain is usually present and may be severe.

Physical examination reveals signs of supraspinatus tendinitis and weakness on active abduction and external rotation. Rotator cuff tears are best diagnosed by MRI, which has high specificity and sensitivity for this disorder.

Treatment initially should include analgesia, corticosteroid injection, and exercise to improve strength and range of motion. Careful monitoring is necessary because patients often have persistent pain and disability. Patients who do not respond to nonsurgical treatment within 4 to 6 weeks should be referred for rotator cuff repair.