Diehr Sabina, Ison David, Jamieson Barbara, Oh Robert
Medical College of Wisconsin, Milwaukee, WI, USA.
J Fam Pract. 2006 Jul;55(7):621-4.
The evaluation of a suspected rotator cuff tear should start with a history and a clinical exam of the shoulder (strength of recommendation [SOR]: B, based on a systematic review of cohort studies). Three clinical test results in particular--supraspinatus weakness, weakness of external rotation, and impingement--or 2 positive tests for a patient older than 60 years were highly predictive of rotator cuff tear (SOR: B, based on individual prospective study). Either magnetic resonance imaging (MRI) or ultrasound can confirm a possible full-thickness tear (SOR: B, based on a systematic review of cohort studies). If a patient has an implantable device prohibiting MRI imaging, conventional arthrography is an alternative (SOR: A, individual randomized controlled trial). Suspected partial-thickness tears are best verified with an ultrasound (SOR: B, based on a systematic review of cohort studies).
对于疑似肩袖撕裂的评估应从肩部的病史和临床检查开始（推荐强度[SOR]：B，基于队列研究的系统评价）。特别是三项临床检查结果——冈上肌无力、外旋无力和撞击征——或者60岁以上患者两项检查结果呈阳性，对肩袖撕裂具有高度预测性（SOR：B，基于个体前瞻性研究）。磁共振成像（MRI）或超声检查均可证实可能存在的全层撕裂（SOR：B，基于队列研究的系统评价）。如果患者体内有植入式装置而无法进行MRI成像，传统关节造影是一种替代方法（SOR：A，个体随机对照试验）。疑似部分厚度撕裂最好通过超声检查来证实（SOR：B，基于队列研究的系统评价）。
