Thursday, August 9, 2007

Investigations for RC Tendonopathy

Invesitgations for Rotator Cuff Tendonopathy:

Firstly physical examination along with symptoms
XRay:
-detect possible anatomical abnormalities eg variations in acromion may give a tendency towards tendonopathy
-detect calcific tendonitis; calcific deposits on supraspinatus tendon may cause pain (although may be present without being the cause of pain), generally found in elder patients (30-50 yrs)
-degenerative changes eg arthritis of AC or GH joint
-may order neck XRay (generally of cervical neck region) in case of suspected neck/nerve damage
All above tests are to rule out other differentials eg nerve damage, arthritis etc
Ultrasound:
-can detect Rotatot cuff tears
-good for assesing tendon of rotator cuff
-can detect fluid eg fluid in subdeltoid bursa is indicative of a full thickness rotator cuff tear
(is an inexpensive and non invasive technique)
MRI:
-can detect suspected tear
-may demonstrate inflammation
-can detect swelling
(not likely to be used in case of tendonopathy as expensive procedure)
Arthroscopy:
-can detect tears
-can fix smaller tears
(invasive procedure)
Arthrogram:
-injection of contrast dye into joint, can reveal tears and abnormalities

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