The duration of symptoms does not correlate with rotator cuff tear severity or other patient-related features: a cross-sectional study of patients with atraumatic, full-thickness rotator cuff tears

Abstract

Introduction The purpose of this cross-sectional study is to determine if the duration of symptoms influences the features seen in patients with atraumatic full thickness rotator cuff tears. Our hypothesis is that increasing duration of symptoms will correlate with more advanced findings of rotator cuff tear severity on MRI, worse shoulder outcome scores, more pain, decreased range of motion, and less strength. Methods 450 patients with full thickness rotator cuff tears were enrolled in a prospective cohort study to assess the effectiveness of nonoperative treatment and factors predictive of success. Duration of patient symptoms were divided into four groups: ≤3 months, 4–6 months, 7–12 months, and >12 months. Data collected at patient entry into the study included: 1.) Demographic data, 2.) History and physical exam data, 3.) Radiographic imaging data, and 4.) Validated patient reported measures of shoulder status. Statistical analysis included a univariate analysis with Kruskal-Wallis test and Pearson tests to identify statistically significant differences in these features for different durations of symptoms Results Longer duration of symptoms does not correlate with more severe rotator cuff disease. Duration of symptoms was not related to weakness; limited range of motion; tear size; fatty atrophy; or validated patient reported outcome measures. Conclusions There is only a weak relationship between the duration of symptoms and features associated with rotator cuff disease. Level of Evidence Level III, Cross Sectional Study

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

“…In total, 56 articles were included (41 cross‐sectional, 11 cohort, 4 case–control). Imaging modalities included 25 ultrasound 16, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 24 MRI 15, 16, 41, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 12 radiographs 27, 30, 49, 53, 55, 62, 65, 66, 67, 68, 69, 70, 3 bone scintigraphy 65, 71, 72, 2 PET 73, 74, and no computed tomography. Of these studies, 10 assessed associations with 2 imaging modalities (16, 27, 30, 41, …”

“…The mean (range) score was 48% 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67 for cohort, 41% 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41...…”

“…Sixteen studies evaluated the relationship of RC tears and symptoms (16, 21, 26, 29, 30, 32, 35, 45, 48, 49, 52, 54, 56, 58, 62, 72) (Tables 1, 2, and 3). Nine evaluated the relationship with shoulder pain 16, 21, 30, 32, 35, 45, 49, 52, 72, 4 with shoulder disability 16, 29, 45, 54, and 8 studies with symptoms using a composite pain and function score 26, 29, 32, 48, 49, 54, 56, 58.…”

“…Nine evaluated the relationship with shoulder pain 16, 21, 30, 32, 35, 45, 49, 52, 72, 4 with shoulder disability 16, 29, 45, 54, and 8 studies with symptoms using a composite pain and function score 26, 29, 32, 48, 49, 54, 56, 58.…”

“…Twelve studies (23, 27, 34, 46, 47, 50, 53, 55, 56, 57, 62, 68) evaluated the relationship between the acromion and symptoms (Tables 1, 2, and 3). Two ultrasound studies 23, 34, 3 MRI studies 47, 50, 57, 1 radiographic study 68, 2 combined MRI and radiographic studies 53, 62 and 1 combined ultrasound and radiographic study 27 evaluated the relationship of the acromion and pain.…”