How Are Rotator Cuff Injuries Diagnosed?

The rotator cuff is the shoulder joint mechanism comprised of muscles and tendons connecting the upper arm bone (humerus), shoulder blades (scapula), and collar bone (clavicle), providing stability and a wide range of motion. When tears occur, the resulting pain and weakness can affect everyday life by limiting joint movement and producing discomfort. 

Nearly 2 million individuals experience rotator cuff injuries every year in the US. Gradual wear and tear, advancing in age, and improper posture are general risk factors. Repetitive overhead motions typical in certain sports (tennis, baseball, football) and occupations (carpentry, construction, painting) can also lead to tendon injuries. Rotator cuff tears can also be sustained during sudden trauma, such as falling on an outstretched hand. 

When damage occurs, the most common symptoms include: 

  • Weakness and pain in the shoulder
  • Joint instability accompanied by a grinding sensation
  • Inability to sleep on the injured area
  • Limited range of motion

Diagnosing Injuries

The evaluating physician will first review the patient's medical history to determine if they're predisposed to rotator cuff injuries and if other underlying issues could be relevant. A physical examination will be used to identify the precise cause of the pain. 

The following step involves imaging tests to better visualize the nature and extent of the damage, with the most common methods used being:

  • X-Rays – usually employed to identify bone spurs and exclude other potential causes like arthritis.
  • Ultrasound – sound waves allow the imaging of muscles and tendons, helping physicians better assess their structure during movement.
  • MRI – this method using radio waves and a powerful magnet is preferred because it provides a more detailed image of the shoulder joint's internal structure.   

Rotator cuff injuries can involve either partial or complete tears of the tendons. If the damage is minimal, the physician may recommend a conservative course of treatment focused on symptom relief and progressive rehabilitation. Surgical intervention is imperative to regain proper function if the damage is extensive or patients don't respond to conservative treatment.