[Rotator cuff diseases in occupational medicine between occupational diseases and accidents: medical-legal considerations].
The authors have gone through the complaints concerning all the cases of shoulder accidents at work filed by the Genoa office of the Italian Workers' National compensation Agency (INAIL) during the two years' period 2006-2007, reviewing in particular those somehow affecting rotator components. The aim of this paper is to assess the real role played by the occupational trauma in the rotator cuff tear. The data gathered so far have shown, on the one hand, a high prevalence of pre-existing inflammatory and degenerative diseases and, on the other, a rather modest influence of the trauma which, for this reason, has usually borne, as an immediate medico-legal consequence, the rejection of a cause-effect relationship between the accident and the rotator cuff lesion, without taking into any account whether the worker was likely to be affected by an occupational disease (ex table Ministerial Decree n. 81 April 9th 2008- item 78). In such cases a systematic and in-depth investigation of the occupational case history is suggested, in order to highlight the possible pre-existence of a former biomechanical overload of the upper limbs, so as to allow the physician to detect a pathology often misdiagnosed.
Spigno
F
F
Di.MEL, Sezione di Medicina del Lavoro, Università degli Studi di Genova, Italy. fabio.spigno@unige.it
Galli
R
R
Casali
C
C
Lagattolla
N
N
De Lucchi
M
M
D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D009784:Occupational Diseases / Q000453:epidemiology*; D009787:Occupational Medicine / Q000331:legislation & jurisprudence; D017006:Rotator Cuff; D055815:Young Adult