The ring (cone) of the rotator cuff consists of the tendons of 4 muscles (supraspinatus, infraspinatus, subcapular, and subscapular), the distal attachment of which on the head of the humerus resembles a cone. The function of this complex is to attract the head of the humerus to the acetabulum and to centralize it, thus preventing the strong deltoid muscle from pulling. This system ensures a smooth range of motion, unparalleled in other joints. In addition, the function of the rotator cuff muscles is, of course, the generation of shoulder rotating forces (external and internal rotation) and a significant contribution to the stabilization of the shoulder joint.
Make an appointment now - to a doctor who specializes in the treatment of a rotator cuff in our hospital
[title]
[image-intro]
[readmore text="Read more"]{/article}
[title]
[image-intro]
[readmore text="Read more"]{/article}
Rotator cuff lesions almost always disrupt this system. In young people, in whom tendon ruptures are usually traumatic, these injuries are always symptomatic and most often qualify for surgery. This applies not only to the total damage visible even on ultrasound, but also to symptomatic, so-called intraspinal or partial damage (e.g. damage to the deep layer of the PASTA type), which are characteristic of sports-active patients, and can only be seen in the MRI examination of the shoulder, ordered after an earlier specialist examination physical.
Degenerative injuries, typical for the elderly, most often arise from chronic microtrauma secondary to disturbances in the position and work of the scapula, and blood circulation disorders causing degeneration of the tendons. This type of damage often does not cause pain for many years due to the adaptation of the shoulder joint and damage compensation. The ailments most often appear after a solstice, fall, lifting a heavy object and are often extremely intense (pain awakening you from sleep, limitation of the range of motion) despite their chronic nature. When treating the elderly, we resort to surgical treatment in the case of severely severe symptoms or no improvement after rehabilitation treatment. It should be emphasized, however, that postponing the reconstruction of damaged tendons usually leads to further tendon degeneration and steatosis.
Paste lesion, MRI image
Complete damage to the supraspinatus tendon with retraction of the tendon MRI
Arthroscopic view of partial damage to the supraspinatus tendon
In the diagnosis of rotator cuff lesions, calcified rotator cuff inflammations (most often in the supraspinatus) are a specific lesion of the inflammatory type. This inflammation is treated by washing the calcium deposit under ultrasound guidance under local anesthesia. If there is no improvement, arthroscopic removal of the deposit should be performed followed by repair of the tendon.
X-ray calcified tendinitis of the supraspinatus muscle
Calcific tendinitis of the supraspinatus seen on MRI
The author of the text: lek.med. Hubert Laprus
