Rotator cuff disease — SCE Rheumatology MCQ

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EasyOsteoarthritis and Soft Tissue RheumatologyRotator cuff diseaseSCE Rheumatology

A 56-year-old painter has lateral shoulder pain worse with overhead activity. Passive range is near normal but painful arc is present between 60 and 120 degrees. Resisted abduction is painful. There is no neck pain or systemic inflammation. What is the most likely diagnosis?

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Correct answer: A — Rotator cuff tendinopathy

Explanation lettering: D = shown as A · A = shown as B · E = shown as C · C = shown as D · B = shown as E

Rotator cuff tendinopathy is best because painful arc with preserved passive movement and resisted abduction pain suggests rotator cuff tendinopathy. A is less suitable because cervical myelopathy causes neurological signs rather than isolated painful arc; B is less suitable because adhesive capsulitis restricts passive and active movement globally; C is less suitable because PMR causes bilateral girdle stiffness with raised inflammatory markers; E is less suitable because septic arthritis causes acute severe pain with systemic features. Clinical pearl: passive range of movement is a key discriminator in shoulder stems.

Reference: Oxford Textbook of Rheumatology; NICE musculoskeletal guidance