Natural history of asymptomatic rotator cuff tears: A longitudinal analysis of asymptomatic tears detected sonographically

Yamaguchi, Ken; Tetro, A.Marc; Blam, Oren; Evanoff, Bradley; Teefey, Sharlene A.; Middleton, William D.

doi:10.1067/mse.2001.113086

Cited by 546 publications

(408 citation statements)

References 15 publications

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“…In 4 studies of mixed quality, an increase in RC tear was associated in the incidence of pain 39, 40, 43, 44, although this was not shown in 2 other studies 41, 42. Two high‐quality, unadjusted studies showed function worsened with increasing RC tear 39, 44.…”

Section: Resultsmentioning

confidence: 99%

“…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, …”

Section: Resultsmentioning

confidence: 99%

“…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...…”

Section: Resultsmentioning

confidence: 99%

“…Six ultrasound studies evaluated the relationship between RC tears and symptoms 39, 40, 41, 42, 43, 44 (Tables 4 and 5). Five studies evaluated the relationship between RC tears and pain persistence or progression 39, 40, 42, 43, 44, 3 with function progression 39, 40, 44, and 4 with symptom progression using composite scores 39, 41, 42, 44.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies evaluated the relationship between RC tears and pain persistence or progression 39, 40, 42, 43, 44, 3 with function progression 39, 40, 44, and 4 with symptom progression using composite scores 39, 41, 42, 44.…”

Section: Resultsmentioning

confidence: 99%

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

Tran

Cowling

Smith

et al. 2018

Arthritis Care & Research

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ObjectiveShoulder symptoms are common, and imaging is being increasingly used to help with management. However, the relationship between imaging and symptoms remains unclear. This review aims to understand the relationship between imaging‐detected pathologies, symptoms, and their persistence.MethodsA systematic review using Medline, EMBASE, Cochrane, and grey literature was conducted to April 2017. The cross‐sectional and longitudinal relationships between imaging‐detected abnormalities and symptoms were analyzed and associations qualitatively characterized by a best‐evidence synthesis based on study design, covariate adjustment, and the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Modalities included ultrasound, magnetic resonance imaging (MRI), radiographs, positron emission tomography (PET), bone scintigraphy, and computed tomography.ResultsA total of 6,569 abstracts was screened and 56 articles were included. In total, 50 studies did not adjust for covariates and 36 analyzed individual pathologies only. The majority of studies showed conflicting results. There was no significant association between most imaging features and symptoms among high‐quality, cross‐sectional studies. There was low‐quality evidence that enhancement of the joint capsule on MRI and increased uptake on PET were associated with symptoms in adhesive capsulitis. Based on high‐quality longitudinal studies, enlarging rotator cuff tears were associated with an increased incidence of symptoms.ConclusionThere were conflicting results on the association of imaging features with shoulder symptoms and their persistence. The existing evidence was very low in quality, based on the GRADE methodology. Further high‐quality studies are required to understand the relationship between imaging and shoulder symptoms and to determine the appropriate role of imaging in care pathways.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

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

Tran

Cowling

Smith

et al. 2018

Arthritis Care & Research

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Evaluating Causation for the Opposite Upper Limb

Melhorn¹,

Talmage²,

Brooks³

et al. 2012

AMA Guides® Newsletter

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Workers’ compensation and personal injury claims often become embroiled in debates about the cause of the clinical presentation. When the primary claim involves an extremity, affected individuals sometimes report subsequent symptoms in the contralateral, previously “normal” limb and often attribute its onset to overuse while favoring the initially involved extremity; such an overuse hypothesis seems plausible, and perhaps intuitively obvious, to some. The concept that favoring one upper limb can result in injury to or illness in the other is not based on scientific evidence and instead is an unsupportable myth. Determining relationships between risk factors or exposures and medical conditions is a complex process that is outlined in the Guides to the Evaluation of Disease and Injury Causation (Causation). A search on PubMed and MEDLARS using the key phrases “opposite uninjured arm” and “uninjured arm” returned only six relevant articles, and the authors report that claims of serious or persisting painful syndromes in the arm or hand opposite the injured one are seldom adequately supported by clinical evidence. Similarly, the literature does not support “favoring” as a reasonable cause for development of symptoms in the contralateral shoulder or elbow. Epidemiological studies can provide general information regarding risk; this information must be filtered by specific steps to assess causal association for a disorder and determine if the injury is work related. Findings then can be applied to the specific individual.

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