J Korean Rheum Assoc.  2007 Dec;14(4):311-321.

Common Misconceptions or Misdiagnosis in Shoulder Disorders

Affiliations
  • 1Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hahc78@hanmail.net

Abstract

Many patients, physicians and even orthopedic surgeons commonly have misconceptions about several shoulder disorders, so they misdiagnose these diseases and treat patients inappropriately. In this article, we describe some common misconceptions and misdiagnosis in shoulder disorders; such as rotator cuff disease, SLAP lesion, clavicle fracture et al. It will be helpful to understand how these disorders can be approached and managed.

Keyword

Common misconceptions; Misdiagnosis; Shoulder disorders

MeSH Terms

Clavicle
Diagnostic Errors*
Humans
Orthopedics
Rotator Cuff
Shoulder*

Figure

  • Fig. 1. Glenohumeral AP view of right shoulder shows sclerosis and irregularity of greater tuberosity.

  • Fig. 2. Acromiohumeral distance is less than 7 mm.

  • Fig. 3. Cuff tear arthropathy showing femoralization of the proximal end of the humerus and acetabula- rization of the coracoacromial arch and glenoid.

  • Fig. 4. Acromion morphology.

  • Fig. 5. 30-degree caudal tilt radiograph depicting anterior- inferior projection of an acromial spur. The solid line designates the anterior cortical margin of the distal clavicle.

  • Fig. 6. (A) Inferior subluxation of humeral head on glenohumeral AP view taken 2 weeks after operation. (B) Inferior subluxation of humeral head on glenohumeral AP view taken 2 weeks after arthroscopic Bankart repair.

  • Fig. 7. (A) (left) High signal intensity not extending to posterior portion of superior labrum, (right) high signal intensity (arrow) in posterior third of superior labrum. (B) (left) Medially curved high signal intensity, (right) laterally curved high signal intensity. (C) (left) Band-like high signal intensity (arrow) with smooth margin, (right) globular and irregular high signal intensity (arrow) in superior labrum. (D) Two high-signal intensity lines (arrowheads) in the superior labrum; the more lateral line (large arrowhead) represents the SLAP tear.

  • Fig. 8. (A) Shortening of right clavicle after conservative treatment. (B) Malunion of left clavicle.

  • Fig. 9. Concavity compression. The supraspinatus muscle is not optimally oriented to depress the head of the humerus against upward pull of the deltoid because the inferiorly directed component of the supraspinatus force is small. Instead, the humeral head is stabilized in the concave glenoid fossa by the compressive action of the cuff muscles. (Modified from Matsen FA III, Lippitt SB, Sidles JA, Harryman DT II. Practical evaluation and management of the shoulder. Philadelphia: WB Saunders, 1994).

  • Fig. 10. (A) Massive rotator cuff tear on MRI scan of right shoulder. (B) Even massive rotator cuff tear can be repaired satisfactorily.

  • Fig. 11. Although massive tear is repaired incompletely, it can be helpful to relieve symptoms.

  • Fig. 12. Articular cartilage was injured by extruded metal anchor.

  • Fig. 13. Blood clot on torn margin suggests acute on chronic rotator cuff tear.


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