General practice & prim · UKMLA & AKT
Rotator cuff injuries
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise rotator cuff injuries — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Anterior-superior or lateral shoulder pain - worse at night and with overhead activities
- Painful arc - pain on active abduction between 60° and 120°, easing beyond 120° (supraspinatus passing under acromion)
- True weakness (not pain-limited) - suggests tear; inability to abduct above 90° characteristic of significant supraspinatus tear
- Muscle wasting in supraspinous/infraspinous fossae - indicates chronic massive tear
- Key tests: Neer's sign, Hawkins-Kennedy (impingement); Jobe's empty can (supraspinatus); Gerber's lift-off (subscapularis); drop arm test (massive full-thickness tear)
Adhesive capsulitis restricts ALL movements (active AND passive); rotator cuff impingement restricts active movement in an arc but full passive range is preserved. If passive external rotation is globally restricted, think frozen shoulder first.
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