A 60-year-old active female with concomitant type 1 slap and rotator cuff tear

Abstract

Rotator cuff tears with concomitant type I SLAP tears present with diffuse shoulder pain and weakness. These combined injuries typically occur in older patients with a degenerative, rather than traumatic etiology. The clinical history is significant for progressively worsening pain and weakness, limited active range of motion, difficulty with overhead activity, and aching night pain. Examination is useful in identifying patterns of weakness as well as provocative maneuvers for pain. Imaging begins with radiographs, but pathology is best confirmed with MRI. Ultrasound may also play a role in identifying rotator cuff pathology. Treatment begins with conservative therapy consisting of NSAIDs, corticosteroid injections, activity modification, and physical therapy. Patients that fail nonoperative candidates may have significant improvement with surgical intervention in the form of a rotator cuff repair with labral debridement and/or biceps tenodesis.