General practice & primary care · UKMLA & AKT
Rotator cuff injuries
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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