History and physical examination provide little guidance on diagnosis of rotator cuff tears

Commentary on: Hermans J, Luime JJ, Meuffels DE, et al. Does this patient with shoulder pain have rotator cuff disease? The Rational Clinical Examination systematic review. JAMA 2013;310:837–47.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Accurate diagnosis of rotator cuff tears can be challenging even for experienced specialists, hence there is a heavy reliance on MRI for aiding diagnosis. This is not only expensive, but can also encourage misdiagnosis, since high percentages of people aged >50 can have cuff tears on imaging but be asymptomatic.1 ,2 Although the structural presence of a tear can be reliably demonstrated using imaging, symptomatic rotator cuff disease is a clinical syndrome, with diagnosis based on the physician's clinical impression alongside radiographical evidence. Herman and colleagues’ article is important, because it aims to provide guidance to clinicians in establishing rotator cuff disease diagnosis based on patient history and physical examination … [1]: {openurl}?query=rft.jtitle%253DJAMA%26rft.volume%253D310%26rft.spage%253D837%26rft_id%253Dinfo%253Adoi%252F10.1001%252Fjama.2013.276187%26rft_id%253Dinfo%253Apmid%252F23982370%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1001/jama.2013.276187&link_type=DOI [3]: /lookup/external-ref?access_num=23982370&link_type=MED&atom=%2Febmed%2F19%2F3%2F108.atom [4]: /lookup/external-ref?access_num=000323561400024&link_type=ISI