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Rotator Cuff Syndrome N027

Document
Last amended 
3 April 2016
Current RMA Instruments:
Reasonable Hypothesis SOP
100 of 2014
Balance of Probabilities SOP
101 of 2014
Changes from Previous Instruments:

SOP Bulletin 178

ICD Coding:
  • ICD-9-CM Codes: 726.10,726.11,726.12
  • ICD-10-AM code M75.1, M75.2, M75.3, M75.4 or M75.5
Brief description:

This is a condition of the muscles surrounding the outside of the shoulder joint. The rotator cuff comprises the muscles that bridge the shoulder joint and act upon it, being classically the supraspinatus, infraspinatus, teres minor and subscapularis.  The RMA SOP also includes the long head of the biceps brachii.  The disease process is inflammatory and degenerative and needs to be symptomatic.  The pain is classically provoked when the shoulder is abducted or anterior flexed through the ranges of movement of the shoulder which activate the rotator cuff muscles, being 60 to 120 degrees. Hence the name ‘painful arc syndrome’.

Confirming the diagnosis:

This diagnosis is made clinically and confirmed by imaging (Ultrasound; MRI scan; CT scan) or arthroscopy.

The relevant medical specialist is an orthopaedic surgeon.

Additional diagnoses covered by these SOPs
  • Bicipital tendinitis or tenosynovitis of shoulder
  • Calcific tendonitis of the shoulder
  • Impingement of the shoulder
  • Subdeltoid or subacromial bursitis of the shoulder
  • Supraspinatus syndrome
Conditions not covered by these SOPs   
  • Adhesive capsulitis of the shoulder*
  • Articular cartilage defect glenohumeral joint#
  • Dislocation* of the shoulder   
  • Fibromyalgia*
  • Frozen shoulder* (Adhesive capsulitis)
  • joint instability* of the shoulder
  • Osteoarthritis* of the shoulder
  • Periarthritis of the shoulder#
  • Polymyalgia rheumatica*
  • Scapulohumeral fibrositis#
  • Sprain or strain* of the shoulder                

* another SOP applies  - the SOP has the same name unless otherwise specified

# non-sop condition

Clinical onset

The clinical onset will be when the relevant symptoms (shoulder pain/ painful arc) first presented.

Clinical worsening

The condition may respond well to treatment (conservative or surgical) or may have a chronic course.  The same activities that can cause the condition can aggravate it, if they are continued.   Permanent worsening would be evidenced by increased pain and decreased function of the affected shoulder.