Expert appraisal in injuries of the shoulder rotator cuff

Abstract

Background: Most of detected changes in the shoulder rotator cuff are the consequence of chronic changes. Fresh injuries of individual parts of the rotator cuff have to be proved without a doubt as soon as possible after the injury. The basic question with regard to any expert appraisal of changes in the shoulder rotator cuff is undoubtedly the determination of post-injury changes as well as the distinction between degenerative changes, changes discovered by chance and fresh injuries of the rotator cuff. A detailed analysis of the clinical picture, the biomechanics of the event and early application of specific imaging diagnostic methods enable certain determination of causal connections between the actual event and the established changes in rotator cuff.Conclusions: A systematic approach to analysis of all data about the condition of the shoulder prior to the injury, certain establishment of connection between the injury event, the first medical surgical, histological and ultrasound results, CT and magnetic resonance, along with the analyses of accompanying changes, enable an expert to give a decisive medical expert appraisal. The latest findings about the biomechanics of rotator cuff injuries which contain an analysis of load on individual parts of the rotator cuff in certain arm positions as well as the knowledge about the progress and causes of the circulation changes in parts of rotator cuff and the role of microtrauma provide for the distinction between the manifestation of silent changes which have been undergoing for a longer time and undoubtedly established fresh injuries of the healthy parts of the rotator cuff. The article presents the phase analysis of established changes in the rotator cuff, including the findings and instructions for providing an expert appraisal of the shoulder rotator cuff following an injury.</p