367: Rotator cuff pathology in the nursing staff of Orthopedic Service, Quito Social Security Hospital

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Acute musculoskeletal pain, Epidemiology, Pain in Special Populations , Imaging (e.g. fMRI, PET, MRS)

Background and Aims: Partial rotator cuff tears are the most frequent acute soft tissue injuries of the shoulder (34%). Risk factors for this condition include age, a history of trauma, and functional demands on the shoulder. These demands have been linked to repetitive movements involving hyperabduction or hyper elevation of the shoulder, as occurs in the daily work activities of nursing staff. The aim of this study is to determine whether or not there is a correlation between acute rotator cuff injuries and the work activities of nursing staff in the orthopedic ward over at least three months.

Methods: Day 1 Assessment
1. Signing of consent
2. Medical history
3. Completion of the data collection sheet: initials, identification data, and background information
4. Sequential bilateral shoulder examination: inspection, palpation, range of motion assessment, specific examination of the rotator cuff and complementary examination
5. Sequential bilateral shoulder ultrasound examination: muscles (belly) and tendons (fibers: insertional, bursal, intrasubstance, articular), bone, and cartilage. Subdeltoid and subacromial bursa, long head of the bicep’s tendon, Rotator interval, Rotator cuff muscles: Subscapularis ,Sternoclavicular and acromioclavicular joints with Mindray Z60 ultrasound machine with the Mindray L14-6P flat-panel transducer (8-12 MHz).
Assessment Day 91
1. Re-assessment and recording of steps 4 and 5

Results: 36 nurses
4 hours of repetitive daily activities with functional demands on the shoulder.
33% reported shoulder pain
They did not sports, and had no history of trauma, surgery, or repetitive activities at home
Evaluation Day 1
Clinical examination of the shoulder: 13.8% (5) had a positive Jobe test on the right shoulder
Ultrasound documented: 4 patients (11.11%) with a partial tear of the supraspinatus, 1 with a partial tear of the infraspinatus, 1 of the subscapularis, and 2 with injury subdeltoid subacromial bursa.
Evaluation on day 91: No changes were found in the clinical or ultrasound findings.

Conclusions: The rotator cuff is a complex musculotendinous structure that stabilizes and provides function to the shoulder. Partial or complete tears are a common shoulder pathology that is not fully repaired, leading to chronicity and pain. Identifying risk factors is a useful approach for prevention. Activities with high shoulder demands, performed for 4 hours a day in the orthopedic department over a period of 3 months by nursing staff at HE CAM, are NOT directly related to rotator cuff pathology, as evidenced by the clinical and ultrasound examinations performed on days 1 and 91.

References: 1. Osma J, Carreño M, Rev Colomb Ort Traum, 2016 (30) (S1) 1-12. Rotator cuff: epidemiology, natural history, risk and prognostic factors. current concept
2. Llopis E, Perez A, Cerezal L. Rotator Cuff. 2021 Apr 13. In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Musculoskeletal Diseases 2021-2024: Diagnostic Imaging [Internet]. Cham (CH): Springer; 2021.
3. Resteghini P et al, Diagnostic Musculoskeletal Ultrasound and Guided Injection, Thieme, 2018
4. Rueda J, Rotator cuff: epidemiology, risk factors, natural history of the disease and prognosis. Review of current concepts, Rev Colomb Ortop Traumatol. 2016
5. Prabhakar, T et al Current concepts on management of cuff tears, Journal of Clinical Orthopedics and Trauma 28 (2022)

Presenting Author: Dr. Mario Paz Mazón
Submitting Author: Mario Paz Mazon

Senior Author: Dr. Mario Paz Mazón

IASP 2026 Global Year theme of Neuropathic Pain: No