Published 17 February 2009, doi:10.1136/bmj.b642
Cite this as: BMJ 2009;338:b642

Letters

Rotator cuff disease

What is rotator cuff disease anyway?

The first 150 words of the full text of this article appear below.

I am not surprised that the study by Ekeberg and colleagues showed no difference between subacromial ultrasound-guided or systemic steroid injection for rotator cuff disease.1

What is rotator cuff disease? I submit no such disease exists. You might as well talk of shoulder pain disease or the long discredited periarthritis.

The diagnostic criteria seem to be pain on abduction (active or passive or both?), up to 49% reduced glenohumeral motion in one direction only (active or passive limitation, or both?), with pain on two resisted movements, and a positive impingement sign (a painful arc?). What is the basis for deciding that this complicated combination of physical signs correlates with rotator cuff disease?

But if it does, what is the logic of trying to treat it by injecting into the subacromial bursa, a different structure? The rotator cuff consists of the tendons of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles . . . [Full text of this article]

Gabriel Symonds, general practitioner1

1 Tokyo, Japan

symonds@tokyobritishclinic.com


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Relevant Article

Subacromial ultrasound guided or systemic steroid injection for rotator cuff disease: randomised double blind study
Ole M Ekeberg, Erik Bautz-Holter, Einar K Tveitå, Niels G Juel, Synnøve Kvalheim, and Jens I Brox
BMJ 2009 338: a3112. [Abstract] [Full Text] [PDF]

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