Ross Mathiasen1,2, Christopher Hogrefe3,4,5. 1. Department of Emergency Medicine, University of Nebraska Medical Center, 981150 Nebraska Medical Center, Omaha, NE, 68198-1150, USA. remathia@unmc.edu. 2. Department of Orthopaedic Surgery, University of Nebraska Medical Center, 981150 Nebraska Medical Center, Omaha, NE, 68198-1150, USA. remathia@unmc.edu. 3. Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Suite 1300, Lavin Family Pavilion - 259 East Erie Street, Chicago, IL, 60611, USA. 4. Department of Medicine, Northwestern University Feinberg School of Medicine, Suite 1300, Lavin Family Pavilion - 259 East Erie Street, Chicago, IL, 60611, USA. 5. Department of Orthopaedic Surgery - Sports Medicine, Northwestern University Feinberg School of Medicine, Suite 1300, Lavin Family Pavilion - 259 East Erie Street, Chicago, IL, 60611, USA.
Abstract
PURPOSE OF REVIEW: To provide a primary care perspective regarding the evaluation and management of shoulder pain and rotator cuff tears. RECENT FINDINGS: In the primary care setting, rotator cuff pathology is commonly encountered. Information regarding the risks of oral medications for the management of the associated pain keeps mounting. Partial-thickness rotator cuff tears remain difficult to diagnose with a single imaging modality. Musculoskeletal education in medical schools and non-orthopaedic residency and fellowship training programs continues to be an area for additional improvement. In the primary care office, the initial evaluation of shoulder pain should include a thorough musculoskeletal evaluation in order to identify the source of the pain (e.g., shoulder, cervical spine, chest wall), as well as the development of an initial treatment plan. Access to imaging modalities such as ultrasound and MRI can vary depending on the resources available in the primary care setting. The identification of patients who may benefit from early surgical referral is imperative for optimizing outcomes.
PURPOSE OF REVIEW: To provide a primary care perspective regarding the evaluation and management of shoulder pain and rotator cuff tears. RECENT FINDINGS: In the primary care setting, rotator cuff pathology is commonly encountered. Information regarding the risks of oral medications for the management of the associated pain keeps mounting. Partial-thickness rotator cuff tears remain difficult to diagnose with a single imaging modality. Musculoskeletal education in medical schools and non-orthopaedic residency and fellowship training programs continues to be an area for additional improvement. In the primary care office, the initial evaluation of shoulder pain should include a thorough musculoskeletal evaluation in order to identify the source of the pain (e.g., shoulder, cervical spine, chest wall), as well as the development of an initial treatment plan. Access to imaging modalities such as ultrasound and MRI can vary depending on the resources available in the primary care setting. The identification of patients who may benefit from early surgical referral is imperative for optimizing outcomes.
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