Shoulder

Rotator cuff tear

Mechanism

In older people usually degenerative, starting in the supraspinatus tendon near its insertion on the greater tubercle. In younger people more often traumatic, after a fall on the outstretched arm or a dislocation.

Recognition

Weakness not explained by pain is the key sign. Drop sign, external rotation lag sign and bear hug each point to a different part of the cuff.

Course

A cuff tear also occurs without complaints, and the proportion rises with age. Imaging showing a tear therefore does not prove that tear causes the pain.

Structures

• Supraspinatus
• Infraspinatus
• Subscapularis
• Teres Minor

Joints involved

• Shoulder joint (glenohumeral joint)

Clinical tests

• Drop sign
• External rotation lag sign
• Bear hug test
• Lift-off test

Sources

• Magee DJ, Manske RC. Orthopedic Physical Assessment, 7e editie. Elsevier. 2021