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http://dx.doi.org/10.3344/kjp.2011.24.2.69

Partial-Thickness Rotator Cuff Tears  

Shin, Keun-Man (Department of Anesthesiology and Pain Medicine, Kang-Dong Sacred Heart Hospital, Hallym University Medical Center)
Publication Information
The Korean Journal of Pain / v.24, no.2, 2011 , pp. 69-73 More about this Journal
Abstract
Although the incidence of partial-thickness rotator cuff tears (PTRCTs) was reported to be from 13% to 32% in cadaveric studies, the actual incidence is not yet known. The causes of PTRCTs can be explained by either extrinsic or intrinsic theories. Studies suggest that intrinsic degeneration within the rotator cuff is the principal factor in the pathogenesis of rotator cuff tears. Extrinsic causes include subacromial impingement, acute traumatic events, and repetitive microtrauma. However, acromially initiated rotator cuff pathology does not occur and extrinsic impingement does not cause pathology on the articular side of the tendon. An arthroscopic classification system has been developed based on the location and depth of the tear. These include the articular, bursal, and intratendinous areas. Both ultrasound and magnetic resonance image are reported with a high accuracy of 87%. Conservative treatment, such as subacromial or intra-articular injections and suprascapular nerve block with or without block of the articular branches of the circumflex nerve, should be considered prior to operative treatment for PTRCTs.
Keywords
injections; intrinsic; nerve block; rotator cuff;
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1 Meister K, Thesing J, Montgomery WJ, Indelicato PA, Walczak S, Fontenot W. MR arthrography of partial thickness tears of the undersurface of the rotator cuff: an arthroscopic correlation. Skeletal Radiol 2004; 33: 136-41.   DOI   ScienceOn
2 Van Dyck P, Gielen JL, Veryser J, Weyler J, Vanhoenacker FM, Van Glabbeek F, et al. Tears of the supraspinatus tendon: assessment with indirect magnetic resonance arthrography in 67 patients with arthroscopic correlation. Acta Radiol 2009; 50: 1057-63.   DOI   ScienceOn
3 Connor PM, Banks DM, Tyson AB, Coumas JS, D'Alessandro DF. Magnetic resonance imaging of the asymptomatic shoulder of overhead athletes: a 5-year follow-up study. Am J Sports Med 2003; 31: 724-7.   DOI
4 Lewis RN. The use of combined suprascapular and circumflex (articular branches) nerve blocks in the management of chronic arthritis of the shoulder joint. Eur J Anaesthesiol 1999; 16: 37-41.   DOI
5 Wassef MR. Suprascapular nerve block. A new approach for the management of frozen shoulder. Anaesthesia 1992; 47: 120-4.   DOI   ScienceOn
6 Naredo E, Aguado P, De Miguel E, Uson J, Mayordomo L, Gijon-Banos J, et al. Painful shoulder: comparison of physical examination and ultrasonographic findings. Ann Rheum Dis 2002; 61: 132-6.   DOI   ScienceOn
7 Brenneke SL, Morgan CJ. Evaluation of ultrasonography as a diagnostic technique in the assessment of rotator cuff tendon tears. Am J Sports Med 1992; 20: 287-9.   DOI   ScienceOn
8 van Holsbeeck MT, Kolowich PA, Eyler WR, Craig JG, Shirazi KK, Habra GK, et al. US depiction of partial-thickness tear of the rotator cuff. Radiology 1995; 197: 443-6.
9 Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M. Rotatorcuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone Joint Surg Br 1995; 77: 296-8.
10 Snyder SJ, Pachelli AF, Del Pizzo W, Friedman MJ, Ferkel RD, Pattee G. Partial thickness rotator cuff tears: results of arthroscopic treatment. Arthroscopy 1991; 7: 1-7.   DOI   ScienceOn
11 Conway JE. Arthroscopic repair of partial-thickness rotator cuff tears and SLAP lesions in professional baseball players. Orthop Clin North Am 2001; 32: 443-56.   DOI   ScienceOn
12 Murrell GA, Walton JR. Diagnosis of rotator cuff tears. Lancet 2001; 357: 769-70.   DOI   ScienceOn
13 Gill TJ, McIrvin E, Kocher MS, Homa K, Mair SD, Hawkins RJ. The relative importance of acromial morphology and age with respect to rotator cuff pathology. J Shoulder Elbow Surg 2002; 11: 327-30.   DOI   ScienceOn
14 Teefey SA, Hasan SA, Middleton WD, Patel M, Wright RW, Yamaguchi K. Ultrasonography of the rotator cuff. A comparison of ultrasonographic and arthroscopic findings in one hundred consecutive cases. J Bone Joint Surg Am 2000; 82: 498-504.   DOI
15 Haahr JP, Andersen JH. Exercises may be as efficient as subacromial decompression in patients with subacromial stage II impingement: 4-8-years' follow-up in a prospective, randomized study. Scand J Rheumatol 2006; 35: 224-8.   DOI   ScienceOn
16 Hyvonen P, Lohi S, Jalovaara P. Open acromioplasty does not prevent the progression of an impingement syndrome to a tear. Nine-year follow-up of 96 cases. J Bone Joint Surg Br 1998; 80: 813-6.   DOI   ScienceOn
17 Checroun AJ, Dennis MG, Zuckerman JD. Open versus arthroscopic decompression for subacromial impingement. A comprehensive review of the literature from the last 25 years. Bull Hosp Jt Dis 1998; 57: 145-51.
18 Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res 1990; 254: 64-74.
19 Davidson PA, Elattrache NS, Jobe CM, Jobe FW. Rotator cuff and posterior-superior glenoid labrum injury associated with increased glenohumeral motion: a new site of impingement. J Shoulder Elbow Surg 1995; 4: 384-90.   DOI   ScienceOn
20 Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder. 1972. J Bone Joint Surg Am 2005; 87: 1399.   DOI   ScienceOn
21 Fukuda H. Partial-thickness rotator cuff tears: a modern view on Codman's classic. J Shoulder Elbow Surg 2000; 9: 163-8.   DOI   ScienceOn
22 Chin PY, Sperling JW, Cofield RH, Stuart MJ, Crownhart BS. Anterior acromioplasty for the shoulder impingement syndrome: long-term outcome. J Shoulder Elbow Surg 2007; 16: 697-700.   DOI   ScienceOn
23 Haahr JP, Ostergaard S, Dalsgaard J, Norup K, Frost P, Lausen S, et al. Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up. Ann Rheum Dis 2005; 64: 760-4.   DOI   ScienceOn
24 Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S. Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion. A study in cadavera. J Bone Joint Surg Am 1988; 70: 1224-30.   DOI
25 Hashimoto T, Nobuhara K, Hamada T. Pathologic evidence of degeneration as a primary cause of rotator cuff tear. Clin Orthop Relat Res 2003; 415: 111-20.   DOI
26 Nho SJ, Yadav H, Shindle MK, Macgillivray JD. Rotator cuff degeneration: etiology and pathogenesis. Am J Sports Med 2008; 36: 987-93.   DOI   ScienceOn
27 Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, et al. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis 1998; 57: 649-55.   DOI   ScienceOn
28 Ogata S, Uhthoff HK. Acromial enthesopathy and rotator cuff tear. A radiologic and histologic postmortem investigation of the coracoacromial arch. Clin Orthop Relat Res 1990; 254: 39-48.
29 Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am 1995; 77: 10-5.   DOI
30 Lohr JF, Uhthoff HK. Epidemiology and pathophysiology of rotator cuff tears. Orthopade 2007; 36: 788-95.   DOI   ScienceOn
31 Neer CS 2nd. Impingement lesions. Clin Orthop Relat Res 1983; 173: 70-7.
32 Chen MJ, Lew HL, Hsu TC, Tsai WC, Lin WC, Tang SF, et al. Ultrasound-guided shoulder injections in the treatment of subacromial bursitis. Am J Phys Med Rehabil 2006; 85: 31-5.   DOI   ScienceOn
33 Yamakado K. The targeting accuracy of subacromial injection to the shoulder: an arthrographic evaluation. Arthroscopy 2002; 18: 887-91.   DOI   ScienceOn
34 Naredo E, Cabero F, Beneyto P, Cruz A, Mondejar B, Uson J, et al. A randomized comparative study of short term response to blind injection versus sonographic-guided injection of local corticosteroids in patients with painful shoulder. J Rheumatol 2004; 31: 308-14.