I fully agree with you. He needs an another opinion. In older people, degenerative tears are common with occur due to aging and are spontaneous. While in a 51 year old, the rotator cuff / shoulder tears are due to an injury. An MR arthrogram is suggested to confirm the diagnosis. A combination of ultrasound, MRI and MR arthrogram would completely clear the picture. Please read this authentic study of the sensitivity of these investigative / imaging modalities in diagnosis;
In a partial thickness tear, physical therapy is the treatment of choice. While in a full thickness tear; arthroscopic surgery (key hole surgery / minimal access surgery) would be necessary.
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
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