文档介绍：Rotator Cuff Injury
Rotator Cuff
Long Head of Biceps
Subscapularis
Supraspinatus, up facet of the humeral greater tuberosity
Infraspinatus, middle facet of the humeral greater tuberosity
Teres minor down facet of the humeral greater tuberosity
Infraspinatus Humeral tuberosity
MRI
Infraspinatus
Teres minor
Supraspinatus
Infraspinatus
Pathophysiology
Intrinsic Factors
Vascular supply (? significance)
Distal 1cm of supraspinatus tendon (early studies)
Degenerative changes
Age related
Change in proteoglycan and collagen content in symptomatic tendons
Pathophysiology
Extrinsic factors
Impingement
Acromial spurs
Type III acromion and decreased geometric area of the supraspinatus outlet
Coracoacromial ligament
AC joint osteophytes
Coracoid process
Glenohumeral instability
Accentuates abnormal loading
Can lead to internal impingement
Repetitive use
Tensile overload
Muscle fatigue
Microtrauma
Mechanism
Traumatic
Pitching
Chronic……
Pain and/or fatigue of cuff
Rotator Cuff dysfunction
Impingement with motion
Diagnose
1、History
Pain on the lateral aspect of the shoulder
Stiffness, esp IR
Cannot lie on that side
Weakness, instability, crepitus
Partial tears more sore and stiffer
Acute tear may have inciting event
Diagnose
2、Physical Exam
Impingement testing
NEER SIGN
Hawkin's test