Diagnosis of Cuff Tear Arthropathy

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Last Updated: Wednesday, January 26, 2005

The necessary and sufficient criteria for the diagosis of cuff tear arthropathy are:

A. History

  1. Limited motion and function
  2. Weakness in elevation and rotation
  3. Diagnosis is supported by previously confirmed cuff tear

B. Physical examination

  1. Limited glenohumeral motion
  2. Evidence of large cuff defect such as:
    • supraspinatus and infraspinatus atrophy
    • weakness of external rotation and elevation
    • superior position of humeral head relative to scapula
    • palpable rotator cuff defect
  3. Bone on bone crepitance

C. Radiographs

  1. Superior displacement of humeral head relative to the glenoid leading to contact with coracoacromial arch
  2. Secondary degenerative changes of the glenohumeral joint
  3. Diagnosis is supported by erosion of the greater tuberosity ("femoralization" of proximal humerus)
  4. Diagnosis is supported by a contoured coracoacromial arch and upper glenoid to produce a socket for the proximal humerus ("acetabularization")
  5. Diagnosis is supported by the collapse of superior subchondral bone of humeral head