Diagnosis of Rotator Cuff Tears.

Last updated Tuesday, January 25, 2005

Diagnosis of full thickness rotator cuff tear

A. History

1. Functionally significant weakness of glenohumeral elevation and/or rotation
2. Age over 30 years, usually over 40 years
3. Diagnosis is supported by a history of sudden unexpected loading of the arm followed by shoulder weakness

B. Physical examination

1. Weakness on elevation and/or rotation
2. Diagnosis is supported by supraspinatus and/or infraspinatus atrophy, subacromial crepitance, and/or palpable defect in rotator cuff

C. Radiographs

1. Diagnosis is supported by upward displacement of humeral head in relation to acromion and by acromial spurring

A. History

1. Compromise of shoulder function in activities requiring rotator cuff function
2. Mechanism for damaging the rotator cuff, such as unanticipated eccentric load applied to elevated arm

B. Physical examination

1. Pain and weakness on tests of rotator cuff function, such as resisted elevation and resisted external rotation
2. Diagnosis is supported by subacromial crepitance

C. Radiographs

1. Diagnosis is supported by upward displacement of humeral head in relation to acromion and by acromial spurring

D. Definite identification

Definite identification of an incomplete thickness cuff lesion by an expert observer using one of the following:

• arthrography,
• arthroscopy,
• or open surgery.