Margit Kooijman

Shoulder vignettes | 45 total 82% of general practitioners would advise or prescribe some kind of pain medication, mostly NSAIDs, whereas only very few physiotherapists indicated they would refer the patient to the general practitioner for medication. In total, 41% of general practitioners would refer for some type of physiotherapy and the majority of physiotherapists indeed indicated they would start treatment, which would consist of exercise therapy and mobilisation mainly. TABLE 3. Management of rotator cuff tear * * multiple responses possible; ** significant at p < 0.05 level; na = not applicable V2 General practitioners (n = 84) Physiotherapists (n = 110) P-value N (%) N (%) Investigations Would not order any tests 8 (10) na X-ray 6 (7) na Ultrasound primary care 35 (42) na Ultrasound secondary care 43 (52) na CT scan 1 (1) na MRI scan 7 (8) na Blood tests (e.g. FBE, ESR) 0 (0) na Consultation management/advice Expectant observation only 5 (6) 12 (11) 0.207 Advice on home exercise 21 (25) 69 (65) ˂ 0.001 ** Activity/work modification 35 (42) 83 (78) ˂ 0.001 ** Psychosocial evaluation 3 (4) 5 (5) 0.709 Mobilisation na 41 (39) Massage na 17 (16) Exercise therapy na 61 (58) Prescribe medication: Over-the-counter- analgesics 19 (23) na Prescription analgesics 15 (18) na Prescription NSAIDs 46 (55) na Administer a glucocorticoid injection: 5 (6) na Referral Would not refer 10 (12) 18 (17) Orthopaedic surgeon 57 (69) na Physiotherapy – exercise therapy 21 (25) na Physiotherapy – mobilisation/massage 3 (4) na Physiotherapy – advice on activities of daily living, work, home exercises 11 (13) na Physiotherapy – not specified 8 (10) na Colleague physiotherapist for ultrasound na 47 (44) GP – not specified na 9 (8) GP for pain medication na 2 (2) GP for investigations (e.g. MRI) na 62 (58) GP for referral to orthopaedic surgeon na 28 (26) Prognosis – likely or very likely to: Recover within 2 weeks 3 (4) 2 (2) 0.445 Recover within 6 weeks 22 (26) 27 (25) 0.794 Recover within 1-2 years 60 (71) 82 (75) 0.627 Have a recurrence within 2 years 6 (7) 7 (6) 0.830 Have permanent difficulties with activities of daily life 15 (18) 12 (11) 0.166 Require surgery 35 (42) 32 (29) 0.068