Acute rotator cuff tear: Do we miss the early diagnosis? A prospective study showing a high incidence of rotator cuff tears after shoulder trauma

• Published in: Journal of shoulder and elbow surgery 2007-03, Vol.16 (2), p.174-180
• Main Authors: Sørensen, Anne K.B., MD, Bak, Klaus, MD, Krarup, Annabel L., MD, Thune, Charlotte H., MD, Nygaard, Marianne, MD, Jørgensen, Uffe, DMSc, Sloth, Carsten, MD, Torp-Pedersen, Søren, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Diseases of the osteoarticular system; Early Diagnosis; Female; Humans; Incidence; Injuries of the limb. Injuries of the spine; Juxtaarticular diseases. Extraarticular rhumatism; Male; Medical sciences; Middle Aged; Multiple Trauma - diagnosis; Multiple Trauma - epidemiology; Orthopedics; Prospective Studies; Rotator Cuff - diagnostic imaging; Rotator Cuff Injuries; Shoulder Joint - diagnostic imaging; Shoulder Joint - injuries; Traumas. Diseases due to physical agents; Ultrasonography
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2006.06.010

The aim of this study was to evaluate the epidemiologic data of patients with an acute soft-tissue injury to the shoulder, with an emphasis on improving the early diagnosis of acute rotator cuff tears. This study included 104 patients, with a median age of 49 years (range, 19-75 years). The patients were evaluated clinically and with ultrasonography at a median of 13 days (range, 3-49 days) after the injury. A total of 60 patients (58%) had some degree of cuff lesion on the ultrasonographic examination. Of these patients, 33 (32%) had a full-thickness rotator cuff tear, 14 (13%) had a partial-thickness cuff tear in the tendon substance, and 13 (13%) had a partial cuff tear at the insertion site on the major tubercle. The injury mechanism or activity at the moment of injury did not correlate with the presence of a rotator cuff lesion, but we found a strong age correlation, with a prevalence of any rotator cuff tear, above 50%, for patients aged above 50 years and with a prevalence of full-thickness tears of 50% in the groups aged 50 to 59 years and aged 60 to 69 years. In conclusion, this study found a high incidence of rotator cuff lesions by further evaluation of patients undergoing consultation at the emergency department, with an inability to perform active abduction above 90° and normal radiographs, after an acute shoulder trauma.