Case Of The Week: A Shoulder Rotator Cuff Injury

Our patient today is a 43-year old man. A few months ago he was moving stuff around in his garage when he felt some sudden pain in his shoulder, like a “pull”.

It was not too bad so he stopped for the day and forgot about it.

Since then, he has this annoying pain, even though he can move his arm quite ok. He’s been taking some painkillers, which make the pain go away for a while—but it always comes back.

Finally he decided to make an appointment with her doctor, to make sure everything was alright.

A shoulder x-ray didn’t show any fractures (as expected, because there was no trauma).

Her doctor then ordered a MRI, suspecting there might be some rotator cuff injury. Indeed, the MRI showed a rotator cuff tear:

MRI showing normal rotator cuff vs tear
This is a typical scenario for rotator cuff tears: you can usually move your arm because your deltoid is working fine, but it hurts. You may have some trouble raising your arm above your head.

Because our patient is young, active and the tear is recent (not from years ago) they decided to go for surgery.

Surgery consists of reimplanting the torn cuff into the bone, using kind of a “screw” like this:

Shoulder surgery for rotator cuff tear (screw on humeral head)

After surgery, it’s important to rest for a while so that the screw won’t “come out”. It takes some months until it heals.

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