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Rotator Cuff Syndrome N027

Last amended 
10 November 2022
Current RMA Instruments
Reasonable Hypothesis SOP
109 of 2022
Balance of Probabilities SOP
110 of 2022
Changes from previous Instruments

SOP Bulletin 233

ICD Coding
  • ICD-10-AM codes 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 is generally 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 tendonitis or tenosynovitis of shoulder
  • Calcific tendonitis of the shoulder
  • Impingement of the shoulder
  • Subacromial impingement syndrome
  • Subdeltoid or subacromial bursitis of the shoulder
  • Supraspinatus syndrome
  • Tendonitis of the long head of the biceps
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.