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System review and meta-analysis
History and physical examination provide little guidance on diagnosis of rotator cuff tears
  1. Nitin B Jain1,
  2. Ken Yamaguchi2
  1. 1Departments of Physical Medicine & Rehabilitation and Orthopedics, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Washington University School of Medicine, St Louis, Missouri, USA
  1. Correspondence to : Dr Nitin B Jain, Brigham and Women's Hospital, 75 Francis Street, BC-4-016, Boston, MA 02115, USA; njain1{at}

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Accurate diagnosis of rotator cuff tears can be challenging even for experienced specialists, hence there is a heavy reliance on MRI for aiding diagnosis. This is not only expensive, but can also encourage misdiagnosis, since high percentages of people aged >50 can have cuff tears on imaging but be asymptomatic.1 ,2 Although the structural presence of a tear can be reliably demonstrated using imaging, symptomatic rotator cuff disease is a clinical syndrome, with diagnosis based on the physician's clinical impression alongside radiographical evidence. Herman and colleagues’ article is important, because it aims to provide guidance to clinicians in establishing rotator cuff disease diagnosis based on patient history and physical examination …

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  • Competing interests KY receives royalties from Zimmer and Tornier related to development of joint arthroplasty systems.