Margit Kooijman

44 TABLE 2. Management of rotator cuff tendinopathy * * multiple responses possible; ** significant at p < 0.05 level; na = not applicable Vignette 2: Acute rotator cuff tear Most general practitioners indicated further investigation by means of ultrasound in primary or secondary care and/or referral to an orthopaedic surgeon was necessary (table 3). Likewise, many physiotherapists indicated they would refer the patient to their general practitioner for these reasons and/or for ultrasound with a colleague. Although impaired movement and not pain is the main complaint, in V1 General practitioners (n = 84) Physiotherapists (n = 110) P-value N (%) N (%) Investigations Would not order any tests 69 (82) na X-ray 10 (12) na Ultrasound primary care 7 (8) na Ultrasound secondary care 4 (5) na CT scan 0 (0) na MRI scan 0 (0) na Blood tests (e.g. FBE, ESR) 4 (5) na Consultation management/advice Expectant observation only 9 (11) 1 (1) 0.002 ** Advice on home exercise 46 (55) 94 (85) ˂ 0.001 ** Activity/work modification 35 (42) 80 (73) ˂ 0.001 ** Psychosocial evaluation 3 (4) 12 (11) 0.058 Mobilisation na 47 (43) Massage na 37 (34) Exercise therapy na 86 (78) Prescribe medication: Over-the-counter- analgesics 21 (25) na Prescription analgesics 8 (10) na Prescription NSAIDs 19 (23) na Administer a glucocorticoid injection: 49 (58) na Referral Would not refer 27 (32) 76 (69) Orthopaedic surgeon 5 (6) na Physiotherapy – exercise therapy 41 (49) na Physiotherapy – mobilisation/massage 5 (6) na Physiotherapy – advice on activities of daily living, work, home exercises 23 (27) na Physiotherapy – not specified 11 (13) na Colleague physiotherapist for ultrasound na 33 (30) GP – not specified na 0 (0) GP for pain medication na 7 (6) GP for investigations (e.g. MRI) na 12 (11) GP for referral to orthopaedic surgeon na 5 (5) Prognosis – likely or very likely to: Recover within 2 weeks 6 (7) 8 (7) 0.972 Recover within 6 weeks 51 (61) 76 (69) 0.224 Recover within 1-2 years 69 (82) 94 (85) 0.533 Have a recurrence within 2 years 28 (33) 17 (15) 0.003 ** Have permanent difficulties with activities of daily life 7 (8) 9 (8) 0.970 Require surgery 0 (0) 1 (1) 0.381