Question

Which condition is NOT likely to feature the painful arc syndrome?

• A. Supraspinatus tendinitis
• B. Subacromial bursitis
• C. Complete supraspinatus tear
• D. Fracture of greater tuberosity humerus

Hint:

Painful arc needs an intact structure still able to catch under the acromion during mid-abduction.

Answer 1

The Correct Option is C

Step 1: Understanding the Question:
Painful arc syndrome is pain felt only in a specific middle range of shoulder abduction, roughly 60 to 120 degrees, because a structure under the acromion gets pinched during that arc. We need the condition that does NOT typically give this pattern.

Step 2: Key Formula or Approach:
The painful arc needs two things: a structure that can still move under the acromion, and impingement of that structure only in the mid-range of abduction, with pain easing again once the arm clears past the acromion. Anything that removes the impinging tissue, or leaves no intact tendon to catch, will not give a true painful arc.

Step 3: Detailed Explanation:
Supraspinatus tendinitis: the inflamed but still intact tendon passes under the acromion during mid-abduction and gets compressed there, producing the classic painful arc.
Subacromial bursitis: the swollen bursa lies exactly in the subacromial space and gets squeezed in the same 60 to 120 degree range, also giving a painful arc.
Fracture of the greater tuberosity of the humerus: the fractured, often slightly displaced bony prominence itself catches under the acromion in that same arc of movement, so a painful arc is still produced.
Complete supraspinatus tear: here the tendon is fully torn through, so there is no continuous tendon left to catch and rub under the acromion in that specific 60 to 120 degree window. Instead of the mid-range pain of an arc, a complete tear more typically causes weakness of active abduction, an inability to initiate or hold abduction, and a positive drop-arm sign. The mechanical impingement that creates a true painful arc needs a structure still in continuity, which a complete tear does not have.

Step 4: Final Answer:
The condition that does not typically feature a painful arc is a complete supraspinatus tear.
\[ \boxed{\text{Complete supraspinatus tear}} \]