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  • Rotator Cuff Tear

    A rotator cuff tear is a common cause of pain and disability among adults. A torn rotator cuff will weaken your shoulder. This means that many daily activities, like combing your hair or getting dressed, may become painful and difficult to do.

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    <p><a href="">Dr. Patrick Chin, MD</a>, MBA, FRCSC, <a href="">Orthopedic Surgeon</a>, discusses rotator cuff tendon tears.</p>

    Dr. Patrick Chin, MD, MBA, FRCSC, Orthopedic Surgeon, discusses rotator cuff tendon tears.

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    <p><a href="">Dr. Jordan Leith, MD</a>, MHSc, FRCSC, Sport Med <a href="">Orthopeadic Surgeon</a>, discusses Rotator Cuff Tears of Shoulder</p>

    Dr. Jordan Leith, MD, MHSc, FRCSC, Sport Med Orthopeadic Surgeon, discusses Rotator Cuff Tears of Shoulder

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    <p>Dr. Grant Lum, MD, CCFP, Dip Sports Med, Sports Medicine Physician, discusses rotator cuff injuries, diagnosis and common treatment options.</p>

    Dr. Grant Lum, MD, CCFP, Dip Sports Med, Sports Medicine Physician, discusses rotator cuff injuries, diagnosis and common treatment options.

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    <p>Audrey Spielmann, MD FRCP(C), discusses shoulder MRI scans.</p>

    Audrey Spielmann, MD FRCP(C), discusses shoulder MRI scans.

  • Symptoms of Rotator Cuff Tendon Tears

    Rotator cuff tendon complex is comprised of four main tendons. 
    The one tendon upfront is called the subscapularis tendon and then there are two tendons up top called the supraspinatus and the infraspinatus tendon. The fourth tendon is on the back and called the teres minor. A local Chiropractor can help with the most commonly torn tendon is the supraspinatus, but obviously the tear can extend and enlarge over time and can include three to four – or three tendons out of four tendons most commonly. So the tear size could be small, medium, large or massive.  


    So as you can see, the main symptom for these patients when they present is usually pain and if the tear is larger in size, subsequently patients will also experience weakness.The rotator cuff tendons are about the shoulder – they surround the shoulder and they basically help rotate the joint.  In essence there are four main tendons that comprise the rotator cuff complex. As you can see here, this is the model of a shoulder with the soft tissue attachments to it. One in the front called the subscapularis tendon and there are two top tendons, top front, top back.

    The top front tendon is called the supraspinatus tendon and the top back tendon is called the infraspinatus tendon. And as you move toward the back, teres minor is the fourth tendon that comprises the whole rotator cuff complex.The most commonly torn tendon is usually the supraspinatus tendon followed by the infraspinatus tendon and then the third tendon that can be torn is the subscapularis tendon. So this is usually the area where patients can get pain from a rotator cuff tear. 

    At times though pain from the shoulder from a rotator cuff tear can be referred down to the elbow. So patients will often describe pain that starts on the outside or lateral aspect of the shoulder, and at times it can radiate to the elbow.As far as the diagnosis of rotator cuff tears, it is a clinical diagnosis based on physical examination by a physician and then followed by obviously some imaging to try and identify the tendons that are torn. 

    The imaging options were comprised from a basic x-ray of the shoulder to look at the bone and joint configuration followed by an ultrasound or an MRI scan of the shoulder to look at the soft tissue structures about the shoulder.  Often seeing a local family physician or a physiotherapist in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also optominal for overall health

    As you know, the rotator cuff tendons are soft tissue, so as a result, the ultrasound and MRI scan will be able to give a better idea of the size of the tear and the characteristics of the tear, potentially. Presenter: Dr. Patrick Chin, Orthopaedic Surgeon, Vancouver, BC

    Now Health Network Local Practitioners: Orthopaedic Surgeon

  • MRI Scans for Shoulder Injuries

    Shoulder injuries are very common in sport, and we see injuries in hockey players, other contact sports, in rugby and football, skiing injuries, and sometimes with tennis or other racquet sports. The main areas that are visualized beautifully with MRI are the tendons and also the labrum. In fact, the labrum can only be visualized with MRI, with no other imaging modality.

    Here is an example of the labrum, which is a fibrous cuff that holds the shoulder in place, and in this particular instance gadolinium has been given to help highlight the labrum. Gadolinium is a contrast agent that we use, and we can see that there is gadolinium undercutting here, consistent with a tear in the labrum.

    So normally the labrum is closely applied to the bone here, which is the bony cuff of the shoulder, and we can see that it’s been detached and the gadolinium is extending underneath it here, indicating that it’s been torn, both in the front and in the back. This can cause a lot of shoulder pain, and is only identified with MRI. A local chiropractor may work with your local family physician and your local physiotherapist to create the best health or rehabilitation plan for your situationIf you have any other questions, as far as the benefit of MRI for shoulder injury, contact your family doctor, your sports medicine physician or an imaging referral centre.

    Presenter: Dr. Audrey Spielmann, Radiologist, Vancouver, BC

    Local Practitioners: Radiologist

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