抄録
Forty consecutive patients (average age,54 years) who underwent surgery for rotator cuff tendinopathy between June 1994 and June 1996 were studied to determine physical findings characteristic to partial-thickness tears of the rotator cuff. There were 19 full-thickness tears,15 partial-thickness tears (3 articular side,6 bursal side,4 intratendinous, and 2 combined), and 6 tendinitis. The evaluated findings were: pain (motion pain, rest pain, and night pain), muscle atrophy (deltoid and infraspinatus), tenderness (greater tuberosity, lesser tuberosity, intertubercular groove, coracoid process, infraspinatus, and acromioclavicular joint), the range of motion (flexion, abduction, internal rotation, and external rotation), impingement signs (Neer and Hawkins), supraspinatus test, external rotation strength, and lift-off test. Among these findings, significant differences were observed in the following: 1) atrophy of the infraspinatus,2)strength in the supraspinatus test, and 3) strength in external rotation. Atrophy of the infraspinatus was more commonly observed in full-thickness tears (79%) than in the partial-thickness tears (7%) and tendinitis (33%)(p=0.0010). Normal strength in the supraspinatus test and in external rotation were less frequently observed in full-thickness tears (0%,11%, respectively) than in the partialthickness tears (33%,53%) and tendinitis (67%,50%)(p=0.0028, p=0.0070). From these results, we conclude that the characteristic physical findings of partial-thickness tears are less atrophy of the infraspinatus and better preserved strength than in full-thickness tears. These findings, however, are similar to those observed in tendinitis, which makes it difficult to differentiate partial-thickness tears from tendinitis.
