Tears at the rotator cuff footprints: imaging characteristic on MRI and ultrasound, evolutions and clinical significance

Congress:

ECR 2012

Poster Number:

C-0521

Type:

Scientific Paper

Keywords:

Musculoskeletal joint, MR

Authors:

S. Martin Martin, J. M. Rapariz, M. L. Pico Fuster, M. A. Garcia, C. Martinez; Palma de Mallorca/ES

DOI:

10.1594/ecr2012/C-0521

DOI-Link:

https://dx.doi.org/10.1594/ecr2012/C-0521

Fig. 1: FIGURE 1: Drawings of the shoulder in the coronal oblique plane showing...

Fig. 2: FIGURE 2: Figure 2a. Drawing of the shoulder in the coronal plane shows a...

Fig. 3: FIGURE 3: Figure 3a. Drawing of the shoulder in the coronal plane shows a...

Fig. 4: FIGURE 4: Figure 4a. Drawing of the shoulder in the coronal plane shows a...

Purpose

PURPOSE: To describe the imaging characteristics on magnetic resonance imaging (MRI) of tears at the rotator cuff footprint.

Methods and Materials

MATERIALS AND METHODS: PATIENTS: This study was performed with approval from our institutional review board. From February 15, 2009, to April 24, 2011, a total of 984 MR images of the shoulder were taken at our institution. Inclusion criteria were the performance of a standardized MRI protocol. Two radiologists, in consensus, who had 2 and 10 years of experience in musculoskeletal radiology, retrospectively reviewed all 984 MR images in order to identify rotator cuff injuries at the level of its distal insertion on the footprint....

Results

RESULTS: Among the 984 MR images that were retrospectively reviewed, 81 MR images from 81 consecutive patients with tears at the rotator cuff footprint were included in our study (8.2%). Thirty-two out of eighty-one (39.5%) footprint lesions were concealed interstitial delamination tears (Fig. 2). Most of the CID tears were located at the supraspinatus tendon (14 patients out of 32 patients with CID tears). Full-thickness tears (Fig. 3) accounted for 25 out of 81 (30%) lesions. Full-thickness tears were predominantly located at the supraspinatus tendon...

Conclusion

CONCLUSION: Most rotator cuff tears occur in a region about 1 cm medial to the tendon insertion. Only a few radiological publications have concentrated on the imaging of tears at the rotator cuff footprint. In our study, most of these lesions were CID and full-thickness tears. Detection of concealed types of tears is of special importance as these lesions might be invisible at arthroscopic shoulder surgery. Partial rotator cuff tears can progress and do not heal on their own.

References

REFERENCES: [1] Codman EA. The shoulder. Boston, MA: Thomas Todd, 1934:123-177. [2] Tuite MJ, Turnbull JR, Orwin JF. Anterior versus posterior, and rim-rent rotator cuff tears: Prevalence and MR sensitivity. Skeletal Radiol 1998, May;27(5):237-43. [3] Vinson EN, Helms CA, Higgins LD. Rim-Rent tear of the rotator cuff: A common and easily overlooked partial tear. AJR Am J Roentgenol 2007, Oct;189(4):943-6. [4] Schaeffeler C, Mueller D, Kirchhoff C, Wolf P, Rummeny EJ, Woertler K. Tears at the rotator cuff footprint: Prevalence and imaging characteristics in 305...