Prevalence of symptomatic rotator cuff ruptures after shoulder trauma: a prospective cohort study.

OBJECTIVE: After shoulder trauma, most fractures and dislocations are easily recognized on radiographic examination; however, the opposite is true for rotator cuff injuries. As a consequence, shoulder complaints may persist or arise due to unrecognized cuff injury. The objective of this study was to investigate the prevalence of shoulder pain and symptomatic rotator cuff ruptures 1 year after shoulder trauma without fracture or dislocation.

PATIENTS AND METHODS: This prospective descriptive study included all the patients presented at our emergency department between January 2007 and January 2008 after a trauma to the shoulder without fracture or dislocation. One year after trauma, this cohort was interviewed by telephone and re-examined at the outpatient clinic on indication.

RESULTS: Of the 217 patients included, all had been pain-free before the trauma. One year after trauma, 69 patients (32%) were still suffering from shoulder pain. Of these patients, 31 were re-examined and 27 had already been re-examined in the meantime. In total, 20 of these 58 patients (34%) were diagnosed with a symptomatic rotator cuff rupture, representing a prevalence of 9% among the included patients.

CONCLUSION: Emergency physicians should be aware that normal radiography does not exclude the presence of a rotator cuff tear in patients with a history of shoulder trauma. Regular follow-up is essential for discovering rotator cuff injuries. In this study, 32% still suffered from shoulder pain 1 year after shoulder trauma, and re-examination revealed a prevalence of 9% symptomatic rotator cuff ruptures.