A specific pattern of shoulder degenerative joint disease that results from

• rotator cuff tears leading to loss of joint congruence
• results in abnormal glenohumeral wear
• leads to the specific pattern of degenerative joint disease

superior migration of humerus

Rotator cuff arthropathy is characterized by the combination of

• rotator cuff insufficiency
• glenohumeral cartilage destruction
• superior migration of the humeral head
• subchondral osteoporosis
• humeral head collapse

Inspection & palpation

• supraspinatus/infraspinatus atrophy
• prominence of humeral head anteriorly (anterosuperior escape) with elevation of arm
• subcutaneous effusion from loss of fluid from capsule

Range of motion

• limitations in active and passive ROM
• crepitus in glenohumeral and/or subacromial joints with ROM
• pseudoparalysis - inability to abduct shoulder

• inability to maintain passively externally rotated shoulder with elbow at 90^o - consistent with a massive infraspinatus tear

• inability to externally rotate or maintain passive external rotation of a shoulder placed in 90^o of elbow flexion and 90^o of shoulder abduction - consistent with teres minor dysfunction

• physiotherapy with a scapular and rotator cuff strengthening exercises
• non-steroidal anti-inflammatories
• subacromial steroid injections - some trials suggest no benefit over NSAIDs and also have risk of increasing degeneration of soft tissues including ligaments and tendons here.
• surgical