Rotator cuff tendonitis in lymphedema: a retrospective case series.
OBJECTIVE
To report rotator cuff tendonitis as a complication of lymphedema and to discuss the possible etiology and treatment options.


METHODS
Retrospective review of 8 cases.


METHODS
University hospital outpatient clinic.


METHODS
A total of 8 breast cancer patients with a history of lymphedema and ipsilateral shoulder pain.


METHODS
Patients with lymphedema and ipsilateral shoulder pain were diagnosed with rotator cuff tendonitis if all of the following 3 tests were positive: supraspinatus test, Neers impingement test, and Hawkins impingement test. Patients diagnosed with rotator cuff tendonitis were prescribed a nonsteroidal anti-inflammatory drug (NSAID) and physical therapy (PT).


METHODS
Improvement in symptoms of shoulder pain at a 4- to 6-week follow-up, as measured by visual analog scale (VAS).


RESULTS
Seven of 8 patients reported a subjective decrease in their symptoms of shoulder pain at a 4- to 6-week follow-up. The average improvement in shoulder pain as measured by VAS was a 4.5-point decrease from the original pain score given. One of 8 patients had a full-thickness supraspinatus tendon tear and required additional decongestive therapy and PT to obtain relief of symptoms.


CONCLUSIONS
Rotator cuff tendonitis is a complication of lymphedema caused by internal derangement of tendon fibers, which may be subject to impingement, functional overload, and intrinsic tendinopathy. Conservative treatment with NSAIDs and PT is a safe and effective treatment.
Herrera
Joseph E
JE
New York-Presbyterian Hospital and Hospitals of Columbia and Cornell, New York, USA.
Stubblefield
Michael D
MD
D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000503:physiopathology*; D020069:Shoulder Pain / Q000150:complications / Q000503:physiopathology; D052256:Tendinopathy / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal