Is This A Simple Rotator Cuff Tear? - Page #1

Author: Shawn Spooner, MD
Editor: Daniel Parker, MD, MPH

Patient Presentation:
50 year-old male with a 5 month history of gradual onset and worsening left shoulder pain.

The pain was located in the anterolateral shoulder and was believed to have started during weightlifting. Pain was aggravated by shoulder elevation and rotation. The patient also reported nocturnal pain and mild shoulder crepitus. The patient reported occasional alcohol use but no tobacco use. His past medical and surgical history was unremarkable. Pain was mildly relieved with over the counter non-steroidal anti-inflammatory drugs.

Physical Exam:
His shoulder showed no signs of atrophy or deformity. No scapular winging was noted. No pain was noted on palpation of the shoulder. A small palpable anterior acromial spur was noted. He had full range of motion but reported painful mid-range abduction. Impingement profile was positive with positive Neer's and Hawkin's tests. He demonstrated moderate weakness in his rotator cuff. Labral, acromioclavicular joint, and bicep provocative testing was negative. His neuro-vascular and neck exam were normal. Thoracic outlet testing was negative.

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