J Korean Orthop Assoc.  2008 Apr;43(2):187-192. 10.4055/jkoa.2008.43.2.187.

Visiting Pattern of Outpatient Clinics and Concordance ofDiagnosis in Rotator Cuff Disorder

Affiliations
  • 1Department of Orthopedic Surgery, Kunkuk University College of Medicine, Seoul, Korea.
  • 2Department of Orthopedic Surgery, Dankook University College of Medicine, Cheonan, Korea. ssjb1990@dku.edu

Abstract

PURPOSE: The purpose of this study is to evaluate the pattern of patient referrals to shoulder surgeons and to evaluate the differences in diagnosis between shoulder surgeons and other doctors.
MATERIALS AND METHODS
From January 2002 to December 2003, we reviewed 695 patients who were diagnosed with rotator cuff disorders; 320 patients were male and 375 were female. The average age was 52 years old. We classified patients into three referral types: 1) outside transfers were referred from other hospitals or local clinics, 2) internal transfers were referred by doctors in our hospital, and 3) self-initiated, which did not have a referral. We classified the diagnostic concordance as Incorrect, Similar, or Correct.
RESULTS
The number of outside transfers was 254, with most referrals from orthopedic surgeons (142 patients). We received 162 internal transfers, mostly from family doctors (44 patients). For outside transfers, diagnosis was incorrect in 60 patients (24%), similar in 135 patients (53%), and correct in 59 patients (23%). Diagnosis in internal transfers was incorrect in 11 patients (7%), similar in 139 patients (86%), and correct in 12 patients (7%).
CONCLUSION
Most physicians seem unfamiliar with rotator cuff disorders. To improve management of these patients, we should increase awareness of these diseases in the general public as well as physicians.

Keyword

Rotator cuff disorder; Visiting pattern; Accuracy of diagnosis

MeSH Terms

Ambulatory Care Facilities
Female
Humans
Male
Orthopedics
Outpatients
Referral and Consultation
Rotator Cuff
Shoulder

Reference

1. Andersen JH, Kaergaard A, Mikkelsen S, et al. Risk factors in the onset of neck/shoulder pain in a prospective study of workers in industrial and service companies. Occup Environ Med. 2003. 60:649–654.
Article
2. Andersson HI, Ejlertsson G, Leden I, Rosenberg C. Chronic pain in a geographically defined general population: Study of differences in age, gender, social class, and pain in localization. Clin J Pain. 1993. 9:174–182.
3. Chun JM. Evaluation, differential diagnosis of the painful shoulder. J Korean Shoulder Elbow Soc. 2003. 6:15–21.
4. Hammond G, Torgerson W, Dotter W, Leach A. The painful shoulder. Instr Course Lect. 1971. 20:83–90.
5. Hasviod T, Johnsen R. Headache and neck or shoulder pain--frequent and disabling complaints in the general population. Scand J Prim Health Care. 1993. 11:219–224.
6. Holmström EB, Lindell J, Moritz U. Low back and neck/shoulder pain in construction workers: occupational workload and psychosocial risk factors. Part 2: Relationship to neck and shoulder pain. Spine. 1992. 17:672–677.
7. Hoozemans MJ, van der Beek AJ, Frings-Dresen MH, van der Woude LH, van Dijk FJ. Pushing and pulling in association with low back and shoulder complaints. Occup Environ Med. 2002. 59:696–702.
8. Jacobsson L, Lindgärde F, Manthorpe R. The commonest rheumatic complaint of over six weeks duration in a twelve-month period in a defined Swedish population: Prevalence and relationships. Scand Rheumatol. 1989. 18:353–360.
9. Kaergaard A, Andersen JH. Musculoskeletal disorders of the neck and shoulders in female sewing machine operators: prevalence, incidence, and prognosis. Occup Environ Med. 2000. 57(8):528–534.
Article
10. Leclerc A, Chastang JF, Niedhammer I, Landre MF, Roquelaure Y. Study Group on Repetitive Work. Incidence of shoulder pain in repetitive work. Occup Environ Med. 2004. 61:39–44.
11. Lee JY, Park JY, Won JH, Lim ST, Park HG, Yoo MJ. The prevalence of shoulder pain in adults over 40 years old in rural area of Chonan City. J Korean Orthop Assoc. 2002. 37:374–378.
Article
12. Lee YS, Kim JY, Cho DY, Kim YH, Kim SH. Diagnostic accuracy of physical examinations in impingement syndrome and rotator cuff tear. J Korean Shoulder Elbow Soc. 2001. 4:186–190.
13. Matsen FA, Titelman RM, Lippitt SB, Wirth MA, Rockwood CA. Rockwood CA, Matsen F, Wirth M, editors. Rotator cuff. The shoulder. 2004. 3rd ed. Philadelphia: Saunders;795–878.
Article
14. Niemi SM, Levoska S, Rekola KE, Keinänen-Kiukaanniemi SM. Neck and shoulder symptoms of high school students and associated psychosocial factors. J Adolesc Health. 1997. 20:238–242.
Article
15. Pope DP, Croft PR, Pritchard CM, Silman AJ. Prevalence of shoulder pain in the community: the influence of case definition. Ann Rheum Dis. 1997. 56:308–312.
Article
16. Smedley J, Inskip H, Trevelyan F, Buckle P, Cooper C, Coggon D. Risk factors for incident neck and shoulder pain in hospital nurses. Occup Environ Med. 2003. 60:864–869.
Article
17. Wang HK, Cochrane T. A descriptive epidemiological study of shoulder injury in top level English male volleyball players. Int J Sports Med. 2001. 22:159–163.
Article
Full Text Links
  • JKOA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr