Rotator Cuff Injury
A 55-year-old man presents with a 3-month history of worsening pain in his right shoulder, particularly when lifting his arm above his head or reaching behind his back. He recalls feeling a sharp pain while lifting a heavy box at work, and the pain has persisted since then. He also reports weakness in the shoulder and difficulty performing daily activities like dressing or reaching for objects on high shelves. There is no numbness or tingling in his arm.
On physical examination, there is tenderness over the shoulder, and pain is reproduced with active shoulder abduction and external rotation. The patient exhibits weakness with resisted abduction, and a positive drop-arm test suggests a rotator cuff tear. An MRI is ordered, which confirms a partial tear of the supraspinatus tendon.
The patient is diagnosed with a rotator cuff injury. Treatment includes physical therapy to improve shoulder strength and flexibility, along with nonsteroidal anti-inflammatory drugs (NSAIDs) for pain management. If symptoms do not improve with conservative treatment, surgical repair may be considered.
a). Playing tennis
b). Lifting a heavy box at work
c). Falling off a ladder
d). Pushing a door open
a). Hawkins-Kennedy test
b). Drop-arm test
c). Phalen’s test
a). X-ray
b). CT scan
c). MRI
d). Ultrasound
a). Corticosteroid injections
b). Surgical repair
c). Physical therapy and NSAIDs
d). Complete immobilization for 6 months
