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RotatorCuffInjury,RotatorCuff,Supraspinatus,upfacetofthehumeralgreatertuberosityInfraspinatus,middlefacetofthehumeralgreatertuberosityTeresminordownfacetofthehumeralgreatertuberosityInfraspinatusHumeraltuberosity,MRI,Infraspinatus,Teresminor,Supraspinatus,Infraspinatus,Pathophysiology,IntrinsicFactorsVascularsupply(?significance)Distal1cmofsupraspinatustendon(earlystudies)DegenerativechangesAgerelatedChangeinproteoglycanandcollagencontentinsymptomatictendons,Pathophysiology,ExtrinsicfactorsImpingementAcromialspursTypeIIIacromionanddecreasedgeometricareaofthesupraspinatusoutletCoracoacromialligamentACjointosteophytesCoracoidprocessGlenohumeralinstabilityAccentuatesabnormalloadingCanleadtointernalimpingementRepetitiveuseTensileoverloadMusclefatigueMicrotrauma,Mechanism,TraumaticPitchingChronic,Diagnose,1、History,PainonthelateralaspectoftheshoulderStiffness,espIRCannotlieonthatsideWeakness,instability,crepitusPartialtearsmoresoreandstifferAcutetearmayhaveincitingevent,Diagnose,2、PhysicalExamImpingementtestingNEERSIGNHawkinstest,Diagnose,2、PhysicalExamSUBSCAPLULARIS肩胛下肌SUPRASPINATUS冈上肌JobesTest,Diagnose,2、PhysicalExamINFRASPINATUS冈下肌,TERESMINOR小圆肌Hornblowerssign:,Diagnose,3、ImagingPlainradiographsUltrasoundMRI,small(1cm),medium(13cm),large(35cm),ormassive(5cm）,Treatment-surgery,三角肌,三角肌,肱三头肌外侧头,肱二头肌,肱骨头,肩胛下肌,
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