Rotator cuff tear

Rotator cuff tear
Other names	Rotator cuff injury, rotator cuff disease
Some of the muscles of the rotator cuff, with a tear in the supraspinatus muscle
Specialty	Orthopedics
Symptoms	Shoulder pain, weakness[1]
Types	Partial, complete[2]
Diagnostic method	Based on symptoms, examination, medical imaging[2]
Differential diagnosis	Subacromial bursitis, rotator cuff tendinitis, impingement syndrome[1][3]
Treatment	Pain medication, specific exercises, surgery[1]
Frequency	Common[2]

Rotator cuff tendinopathy is a process of senescence. The pathophysiology is mucoid degeneration.^[4] Most people develop rotator cuff tendinopathy within their lifetime.^[5]

As part of rotator cuff tendinopathy, the tendon can thin and develop a defect. This defect is often referred to as a rotator cuff tear. Acute, traumatic rupture of the rotator cuff tendons can also occur, but is less common. Traumatic rupture of the rotator cuff usually involves the tendons of more than one muscle.^[6]

Rotator cuff tendinopathy is, by far, the most common reason people seek care for shoulder pain.^[7] Pain related to rotator cuff tendinopathy is typically on the front side of the shoulder, down to the elbow, and worse reaching up or back. Diagnosis is based on symptoms and examination.^[8] Medical imaging is used mostly to plan surgery and is not needed for diagnosis.

Treatment may include pain medication such as NSAIDs and specific exercises.^[1] It is recommended that people who are unable to raise their arm above 90 degrees after two weeks should be further assessed.^[9] Surgery may be offered for acute ruptures and large attritional defects with good quality muscle. The benefits of surgery for smaller defects are unclear as of 2019.^[1][10]