RESUMEN
In the general population, shoulder pain is a common musculoskeletal problem. Older people are frequently affected, and the most common causes of shoulder pain are the problems with rotator cuffs which are seen in primary care practice. The incidence of rotator cuff tear increases with advanced age and it has been estimated that the prevalence of shoulder pain in older patients ranges from 21% to 27%.(1)Tendons are thick, fibrous tissues that transmits muscle-generated force to the bones and thus generates joint movement. Repeated activities and complex muscle-tendon overuse can damage tendons that lead to pain and decrease function.(2)The supraspinatus muscle is a part of the rotator cuff of shoulder.(3) The inflammation of a muscle tendon causes tendinitis and it has varying levels of pain. Supraspinatus tendonitis is an inflammation of supraspinatus tendon often associated with shoulder impingement syndrome.(4) The Supraspinatus tear that causes the supraspinatus tendon to affect the acromion leading to pain is the cause of Supraspinatus Tendinitis. The main cause of the Supraspinatus tear is constant pressure, increased workload and wear and tear associated with age.(5)Total loss of active abduction at the glenohumeral joint is due to a complete tear of supraspinatus.(6) Supraspinatus tendonitis complications include leading to a rotator cuff tear. Initially, rotator cuff tears were almost identified as secondary to tendon haemorrhage and tendonitis products of untreated impingement.(7)The primary purpose of rehabilitation to achieve short-term and long-term goal, patient education and consistent plan of care. The patient's awareness on the need to take non-operative steps, improvement, and the availability of choices will assist them in being active participants in their treatment.(7)
RESUMEN
Hepatocellular carcinoma is one of the most prevalent cancers in the world, particularly in Asia and part of Africa. Hepatocellular carcinoma usually spreads o the lung and regional lymph nodes and its clinical presentation with bone metastasis to scapulae is very rare. We experienced a patient who was a 60-year-old female, visited for unilateral shoulder pain with previous hepatocellular carcinoma history. The physical examination suggested supraspinatus tear and joint problem, but pain nature was atypical. In further MRI imaging, scapular metastasis with full thickness tear of supraspinatus was detected. So we confirmed scapular metastatic lesion by hepatocellular carcinoma and transferred to gastrointestinal department for intensive care, but she discharged to home her own way. She expired with dyspnea and heart arrest 1 month later. We report the scapular metastasis of hepatocellular carcinoma with total supraspinatus tendon rupture.