Rotator cuff arthropathy is a spectrum of degenerative disease that develops due in a rotator cuff deficient shoulder joint. The term encompasses both rotator cuff tendinopathic change as well as associated joint generative change.
Women are affected more than men and it affects the dominant shoulder more than the non-dominant side 1.
Most patients have shoulder pain, effusions and reduction range of motion. Weakness is usually that seen in cuff tears.
high riding humerus
- superior migration of the humeral head with decreased acromiohumeral distance
- "acetabularisation" of the coracoacromial arch: pseudoarticulation of the humerus with the undersurface of the acromion causing concave acromial erosion and increased sclerosis 1,3
- this can lead to impingement
- decreased joint space in the superior aspect of the glenohumeral joint and associated osteoarthritic changes (compared with primary OA where the wear is inferomedial on the humeral head and posterior along the glenoid) 1
- "femoralisation" of the humerus: erosion and rounding of the greater tuberosity 3
- osteopenia of the proximal humerus and acromion
Treatment and prognosis
Conservative management includes NSAIDs and rehabilitation. Surgical management includes joint fusion or replacement by hemiarthroplasty or reverse total shoulder arthroplasty 3, depending on the severity of the disease.
History and etymology
It was first reported by Neer et al. in 1983 2.
- 1. Ecklund KJ, Lee TQ, Tibone J et-al. Rotator cuff tear arthropathy. J Am Acad Orthop Surg. 2007;15 (6): 340-9. Pubmed citation
- 2. Neer CS, Craig EV, Fukuda H. Cuff-tear arthropathy. J Bone Joint Surg Am. 1984;65 (9): 1232-44. Pubmed citation
- 3. Eajazi A, Kussman S, LeBedis C, Guermazi A, Kompel A, Jawa A, Murakami AM. Rotator Cuff Tear Arthropathy: Pathophysiology, Imaging Characteristics, and Treatment Options. AJR. American journal of roentgenology. 205 (5): W502-11. doi:10.2214/AJR.14.13815 - Pubmed