Diagnostic labels for rotator cuff disease

Does the use of various diagnostic labels influence the decision to undergo surgery?

Rotator cuff disease is described with a wide variety of terms. The perceived need for surgery is greatest when the term “rotator cuff tear” is used. Conversely, “bursitis” is associated with a lower perceived need for surgery.

The term "bursitis" is also associated with a lower need for imaging, while the opposite is the case for “subacromial impingement syndrome”.

Therefore, the researchers recommend that these two terms associated with increased need for surgery and imaging are avoided when dealing with patients with rotator cuff disease.

The authors found small differences between diagnostic labels in the primary outcome (need for surgery), which may have a substantial impact at the population level in terms of healthcare resource use.

However, considering that the need for surgery is usually low in these cases, strategies such as explaining that imaging findings to patients are common in people without pain might have more impact than avoiding certain labels.

> From: Zadro et al., J Orthop Sport Phys Ther 51 (2021) 401-411 (Epub ahead of print). All rights reserved to Journal of Orthopaedic & Sports Physical Therapy. Click here for the online summary.

Expert opinion

Although the phrase “A rose by any other name would smell as sweet” may have served Romeo’s purpose, it may not be true when it comes to communicating to patients with musculoskeletal conditions. Both this study and, for example, an editorial piece in the British Journal of Sports Medicine tell us of the potential dangers of using certain labels, especially in conditions that are often low-risk and self-limiting.

We must consider that in front of us is a patient (a person) that has come to us in a more fragile state than usual, and hearing terms such as “tear”, “degenerative”, and “impingement” may worsen their fears and make them see their condition as a life sentence. Thus, it seems important to provide patient education in a more reassuring manner and allow patients to feel encouraged to deal with their condition rather than cause further alarm.

Signup for our weekly or monthly newsletter and get notified on updates on the themes you're interested in:

Please enable the javascript to submit this form

Anatomy & Physiotherapy is a joint venture
between SoPhy & Sharing Science

Summaries on Physiotherapy B.V.
Berkenweg 7
Postbus 1161
3800 BD Amersfoort
The Netherlands

Chamber of commerce: 74973738
Bank: NL72ABNA0849809959
V.A.T. number: NL860093530B01

Sharing Science
Rijksweg Zuid 99
6134 AA Sittard
The Netherlands
Chamber of Commerce: 58306862