Silent Rotator Cuff Tears Common in Older Women

July 05, 2013

By Megan Brooks

NEW YORK (Reuters Health) Jul 05 - Postmenopausal women may develop full thickness rotator cuff tears and not know it.

In a study of pre- and postmenopausal women, investigators from Italy found a nearly three-fold increase in asymptomatic rotator cuff full-thickness tears in the older women.

"Because asymptomatic tears have a great potential to evolve into symptomatic painful shoulder, a precocious discovery of this pathology may allow the planning of preventive and therapeutic measures," they point out in a report online June 10 in Menopause.

Rotator cuff tendon tears increase with age, but no study until now has specifically addressed prevalence changes in women from premenopause to postmenopause.

Dr. Michelle Abate and colleagues studied 110 women older than 44 years with regular menstrual cycles (the preM group) and 122 women who had not had a menstrual period for at least two years but no more than seven years (the postM group).

All of the women were free of shoulder pain/functional impairment (spontaneous or during usual activities of daily living) and none were on long-term treatment with steroids or nonsteroidal anti-inflammatory drugs or had a history of shoulder trauma or surgical operation, rheumatic disorders, endocrinopathies, malignancies or systemic diseases (renal, hepatic, and cardiac insufficiencies).

The researchers found that the prevalence of full-thickness tears (mainly localized in the supraspinatus tendon of the dominant side) was significantly higher in the postM group (8.9% vs. 3.1%), with small, medium, and large tears in 60%, 20%, and 20% of cases, respectively.

On multiple logistic regression analysis, the probability of detecting a tear in both groups was positively related to high body mass index and lower levels of HDL cholesterol.

"These findings are in agreement with literature data, which show that obesity, high cholesterol, and diabetes may be causative factors for tendon degeneration," the investigators say.

"On the basis of this research, health providers should be aware that women in the post-menopausal period could be prone to have tendon problems (not only in the shoulder) due to dismetabolic alterations (hormones, lipid and glucose levels and so on)," Dr. Abate of University G. d'Annunzio in Chieti, Italy, told Reuters Health

"From my point of view, women in the post-menopausal period, even asymptomatic, should be evaluated by means of an ultrasound exam (cheap, not harmful) of the shoulder and blood dosages (hormones, lipid and glucose levels and so on) in order to prevent major damage (tear) and to correct risk factors," she added.


Menopause 2013.


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