[Ultrasonographic appearance of the rotator cuff in elderly subjects]

Some special points must be taken into consideration when diagnosing complaints of the shoulder joint in older patients by means of sonography. Such patients not only have a higher incidence of systemic disease, but also--as we know from autopsies--a large percentage of rotator cuff tears. These changes--with the exception of small partial tears--can be recognized sonographically with a high degree of certainty. Prospective sonographic studies have provided us with information that the incidence of rotator cuff tears rises from 25% in patients in their fifties to 50% in patients in their seventies. These studies enabled us to explain the hitherto unknown clinical relevance of these changes. In general, the patients complained of little pain, but when large tears were present, there was usually a clear loss of function, which however was astonishingly well tolerated. These findings would call for caution in indicating complicated reconstructive surgery.