Hopp til innhold
NHI.no
Annonse

Rotatorkappen, skade: Diagnosen

Det må klargjøres om tilstanden skyldes en skade eller en belastningssykdom, og hvordan tilstanden har oppstått. Ved belastningslidelser har man ofte en lang sykehistorie med gjentatte skader eller belastninger, eventuelt behandling med kortisonsprøyter i området. Det typiske er at man opplever at smerte og svakhet forverres når man utfører aktiviteter i skuldernivå, og/eller når armen løftes utover til siden og man prøver å føre den bakover. Pasienter med tendinose eller overrivning i rotatorkappen har ofte smerter når de ligger på armen.

Annonse

Legen vil foreta en grundig undersøkelse av skulderen din. Det innebærer å vurdere bevegelighet, styrke i ulike muskelgrupper, om bestemte bevegelser er smertefulle. Ved uttalte plager kan det være aktuelt å få utført ultralyd- eller MR-undersøkelse.

Dette dokumentet er basert på det profesjonelle dokumentet Rotatorcuff skade . Referanselisten for dette dokumentet vises nedenfor

  1. Di Benedetto P, Mancuso F, Tosolini L, et al. Treatment options for massive rotator cuff tears: a narrative review. Acta Biomed. 2021 Jul 26;92(S3):e2021026. PMID: 34313657. PubMed
  2. Dang A, Davies M. Rotator Cuff Disease: Treatment Options and Considerations. Sports Med Arthrosc Rev. 2018 Sep;26(3):129-133.PMID: 30059447. PubMed
  3. Lazarides AL, Alentorn-Geli E, Choi JH, et al. Rotator cuff tears in young patients: a different disease than rotator cuff tears in elderly patients. J Shoulder Elbow Surg. 2015 Nov;24(11):1834-43. PMID: 26209913. PubMed
  4. Tashjian RZ. Epidemiology, natural history, and indications for treatment of rotator cuff tears. Clin Sports Med. 2012 Oct;31(4):589-604. doi: 10.1016/j.csm.2012.07.001. Epub 2012 Aug 30. PMID: 23040548. PubMed
  5. Nyffeler RW, Schenk N, Bissig P. Can a simple fall cause a rotator cuff tear? Literature review and biomechanical considerations. Int Orthop. 2021 Jun;45(6):1573-1582.PMID: 33774700. PubMed
  6. Matsen FA. Rotator-cuff failure. N Engl J Med 2008; 358: 2138-47. PubMed
  7. Bauer S, Okamoto T, Babic SM, et al. Understanding shoulder pseudoparalysis: Part I: Definition to diagnosis. EFORT Open Rev. 2022 Mar 17;7(3):214-226. PMID: 35298415. PubMed
  8. Tamai K, Hamada J, Nagase Y, et al. Can magnetic resonance imaging distinguish clinical stages of frozen shoulder? A state-of-the-art review. JSES Rev Rep Tech. 2024 May 15;4(3):365-370. PMID: 39157226. PubMed
  9. Avdeling for allmennmedisin, Universitetet i Oslo. Trygg på skulder i primærhelsetjenesten. Faglig veileder. Publisert mars 2019. Nettsiden besøkt 16.04.19. www.helsebiblioteket.no
  10. Dunn WR, Schackman BR, Walsh C et al. Variation in orthopaedic surgeons' perceptions about the indications for rotator cuff surgery. J Bone Joint Surg Am 2005; 87: 1978-84. PubMed
  11. Lenza M, Buchbinder R, Takwoingi Y, Johnston RV, Hanchard NCA, Faloppa F. Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD009020. DOI: 10.1002/14651858.CD009020.pub2. DOI
  12. Kukkonen J, Joukainen A, Lehtinen J, et al. Treatment of Nontraumatic Rotator Cuff Tears: A Randomized Controlled Trial with Two Years of Clinical and Imaging Follow-up. J Bone Joint Surg Am. 2015 Nov 4;97(21):1729-37. PubMed
  13. Piper CC, Hughes AJ, Ma Y, et al. Operative versus nonoperative treatment for the management of full-thickness rotator cuff tears: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2017 Nov 21. pii: S1058-2746(17)30628-6. doi: 10.1016/j.jse.2017.09.032. (Systematic Review) PMID: 29169957 PubMed
  14. Moosmayer S, Lund G, Seljom US, et al. At a 10-Year Follow-up, Tendon Repair Is Superior to Physiotherapy in the Treatment of Small and Medium-Sized Rotator Cuff Tears. J Bone Joint Surg Am. 2019 Jun 19;101(12):1050-1060. PMID: 31220021 PubMed
  15. Ramme A, Robbins C, Patel K, et al. Surgical Versus Nonsurgical Management of Rotator Cuff Tears: A Matched-Pair Analysis. J Bone Joint Surg Am. 2019; 101: 1775-82. pmid:31577683 PubMed
  16. Boudreault J, Desmeules F, Roy JS, et al. The efficacy of oral non-steroidal anti-inflammatory drugs for rotator cuff tendinopathy: a systematic review and meta-analysis. J Rehabil Med. 2014 ;46(4):294-306. doi: 10.2340/16501977-1800.
  17. Hanratty CE, McVeigh JG, Kerr DP, et al. The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. Seminars in Arthritis and Rheumatism 2012; 42(3): 297-316. pmid: 22607807 PubMed
  18. Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg 2009; 18: 138-60. PubMed
  19. Morse K, Davis AD, Afra R, Kaye EK, Schepsis A, Voloshin I. Arthroscopic versus mini-open rotator cuff repair: a comprehensive review and meta-analysis. Am J Sports Med 2008; 36; 1824-8.
  20. Seida JC, LeBlanc C, Schouten JR, et al. Systematic review: nonoperative and operative treatments for rotator cuff tears. Ann Intern Med 2010; 153: 246-55. Annals of Internal Medicine
  21. Karjalainen TV, Jain NB, Page CM, et al. Subacromial decompression surgery for rotator cuff disease. Cochrane Database Syst Rev. 2019 Jan 17;1:CD005619. doi:10.1002/14651858.CD005619.pub3. The Cochrane Library
  22. Kim YS, Lee HJ, Park I, et al. Are Delayed Operations Effective for Patients With Rotator Cuff Tears and Concomitant Stiffness? An Analysis of Immediate Versus Delayed Surgery on Outcomes. Arthroscopy. 2014 Oct 8.
  23. Houck DA Kraeutler MJ Schuette HB, et al. Early versus delayed motion after rotator cuff repair. Am J Sports Med. 2017 Mar 1:363546517692543 . doi:10.1177/0363546517692543 DOI
  24. Jenssen KK, Lundgreen K, Madsen JE, Kvakestad R, Pripp AH, Dimmen S. No Functional Difference Between Three and Six Weeks of Immobilization After Arthroscopic Rotator Cuff Repair: A Prospective Randomized Controlled Non-Inferiority Trial. Arthroscopy. 2018 Oct;34(10):2765-2774. Epub 2018 Sep 6. PMID: 30195953. PubMed
  25. Storheim K, Gjersing L, Bølstad K, Risberg MA. Sjokkbølge- og trykkbølgebehandling ved kroniske muskel- og skjelettsmerter. Tidsskr Nor Legeforen 2010; 130: 2360-4. Tidsskrift for Den norske legeforening
  26. Zhao JG, Zhao L, Jiang YX, et al. Platelet-Rich Plasma in Arthroscopic Rotator Cuff Repair: A Meta-Analysis of Randomized Controlled Trials. Arthroscopy. 2014 Sep 30.
  27. Chen X, Jones IA, Park C, et al. The Efficacy of Platelet-Rich Plasma on Tendon and Ligament Healing: A Systematic Review and Meta-analysis With Bias Assessment. Am J Sports Med. 2017 Dec 1:363546517743746. PMID: 29268037 PubMed
  28. Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am 1995; 77: 10-15. PubMed
  29. Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M. Rotator-cuff changes in asymptomatic adults: the effect of age, hand dominance and gender. J Bone Joint Surg Br 1995; 77: 296-8. PubMed
Annonse
Annonse