title: Prevalence of symptomatic rotator cuff ruptures after shoulder trauma: a prospective cohort study.
abstract: OBJECTIVE
  After shoulder trauma, most fractures and dislocations are easily recognized on radiographic examination; however, the opposite is true for rotator cuff injuries. As a consequence, shoulder complaints may persist or arise due to unrecognized cuff injury. The objective of this study was to investigate the prevalence of shoulder pain and symptomatic rotator cuff ruptures 1 year after shoulder trauma without fracture or dislocation.
  
  
  METHODS
  This prospective descriptive study included all the patients presented at our emergency department between January 2007 and January 2008 after a trauma to the shoulder without fracture or dislocation. One year after trauma, this cohort was interviewed by telephone and re-examined at the outpatient clinic on indication.
  
  
  RESULTS
  Of the 217 patients included, all had been pain-free before the trauma. One year after trauma, 69 patients (32%) were still suffering from shoulder pain. Of these patients, 31 were re-examined and 27 had already been re-examined in the meantime. In total, 20 of these 58 patients (34%) were diagnosed with a symptomatic rotator cuff rupture, representing a prevalence of 9% among the included patients.
  
  
  CONCLUSIONS
  Emergency physicians should be aware that normal radiography does not exclude the presence of a rotator cuff tear in patients with a history of shoulder trauma. Regular follow-up is essential for discovering rotator cuff injuries. In this study, 32% still suffered from shoulder pain 1 year after shoulder trauma, and re-examination revealed a prevalence of 9% symptomatic rotator cuff ruptures.
authors.affiliation: aDepartment of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam bDepartment of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam cDepartment of Trauma Surgery, Medical Center Alkmaar, Alkmaar dGenetic Epidemiologist, Research Center Linnaeus Institute, Spaarne Hospital eDepartment of Orthopedic Surgery, Spaarne Hospital, Hoofddorp, The Netherlands.
authors.forename: Kars P
authors.initials: KP
authors.lastname: Valkering
authors.forename: Remco D
authors.initials: RD
authors.lastname: Stokman
authors.forename: Taco S
authors.initials: TS
authors.lastname: Bijlsma
authors.forename: Richard M
authors.initials: RM
authors.lastname: Brohet
authors.forename: Arthur
authors.initials: A
authors.lastname: van Noort
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D061212:Memory, Episodic; D008875:Middle Aged; D015995:Prevalence; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000453:epidemiology* / Q000209:etiology; D000070599:Shoulder Injuries; D020069:Shoulder Pain / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult