shoulder

Rotator Cuff Tears

intermediate

6 min

28 marks

6 questions

Clinical Scenario

A 58-year-old right-hand dominant male carpenter presents with a 12-month history of progressive right shoulder pain and weakness. He reports difficulty with overhead activities and night pain affecting sleep. There was no specific injury. Clinical examination reveals positive Jobe's test (supraspinatus weakness), positive external rotation lag sign, and weakness of external rotation in adduction. There is no pseudoparalysis. Range of motion shows 150° forward flexion and 40° external rotation.

MRI of the shoulder is provided.

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Clinical image for Rotator Cuff Tears

Source: Educational MRI demonstrating a grade 3 rotator cuff tear • OrthoVellum Medical Education Team • OrthoVellum Educational Use

Questions

Question 1 (4 marks)

Describe the anatomy of the rotator cuff. What are the functions of each muscle?

Question 2 (5 marks)

How would you clinically assess a patient with suspected rotator cuff pathology? Describe the key examination tests.

Question 3 (6 marks)

Describe the imaging findings that determine reparability of a rotator cuff tear. What classification systems are used?

Question 4 (5 marks)

What are the indications for surgical repair of rotator cuff tears? Describe your approach to this patient.

Question 5 (4 marks)

Describe the principles and techniques of rotator cuff repair. What are the options for massive irreparable tears?

Question 6 (4 marks)

What factors affect outcome after rotator cuff repair? What is the expected re-tear rate?