MR Imaging of Rotator Cuff Injury: What the Clinician Needs to Know1

Department of Radiology, University of Michigan Medical Center, 1500 E Medical Center Dr, TC-B1-132G, Ann Arbor, MI 48109-0326, USA.
Radiographics (Impact Factor: 2.6). 07/2006; 26(4):1045-65. DOI: 10.1148/rg.264055087
Source: PubMed


The rotator cuff muscles generate torque forces to move the humerus while acting in concord to produce balanced compressive forces to stabilize the glenohumeral joint. Thus, rotator cuff tears are often associated with loss of shoulder strength and stability, which are crucial for optimal shoulder function. The dimensions and extent of rotator cuff tears, the condition of the involved tendon, tear morphologic features, involvement of the subscapularis and infraspinatus tendons or of contiguous structures (eg, rotator interval, long head of the biceps brachii tendon, specific cuff tendons), and evidence of muscle atrophy may all have implications for rotator cuff treatment and prognosis. Magnetic resonance imaging can demonstrate the extent and configuration of rotator cuff abnormalities, suggest mechanical imbalance within the cuff, and document abnormalities of the cuff muscles and adjacent structures. A thorough understanding of the anatomy and function of the rotator cuff and of the consequences of rotator cuff disorders is essential for optimal treatment planning and prognostic accuracy. Identifying the disorder, understanding the potential clinical consequences, and reporting all relevant findings at rotator cuff imaging are also essential.

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    • "In our patients, the most frequent impingement in both the men and the women was subacromial impingement. This impingement is connected with a trauma of the supraspinatus tendon in the reduced subacromial space between the superior surface of the humeral head and the inferior surface of the acromion [9]. According to the assessment of the dependencies between categorical parameters using the 2 test, it was obvious that in our group SAI usually occurred more frequently without simultaneous glenohumeral trauma, glenohumeral degeneration, acromioclavicular trauma, or lesions of the glenohumeral or acromioclavicular ligaments. "
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    ABSTRACT: Background: This retrospective study reports the types, frequency, and relationships of lesions affecting a malfunctioning shoulder joint. Aims: Determination of the frequency and mutual relationships of lesions of the shoulder joint in cases of malfunction. Methods: In a set of 79 patients, which consisted of 55 men and 24 women sent for an MRI during a period of 14 months, we retrospectively evaluated the frequency and mutual relationships between lesions of the structures of the shoulder joint, specifically: lesions of the long head of the biceps tendon; superior labral tear from anterior to posterior (SLAP) lesions; glenohumeral traumatic changes; glenohumeral degenerative changes; acromioclavicular degenerative changes; acromioclavicular traumatic changes; pathological bursae, and lesions of the glenohumeral and acromioclavicular ligaments. We evaluated the frequency of representation of subacromial, subcoracoid, and posterosuperior impingements. Results: 30.4% of the patients had the simultaneous occurrence of two lesions of the shoulder joint, 25.3% lesions of three structures, and 19% lesions of one structure. The most common types of lesions were: bursae fillings in 17.2%; acromioclavicular degenerations in 15.7%; lesions of the long head of the biceps in 15.2%, and SLAP lesions in 12.6%. Conclusion: In the majority of cases, we found combined and simultaneous lesions of more than one structure of the shoulder joint. The most frequent pathological findings in our group were the presence of a filled bursa or bursae (34 patients, 17.2%), acromioclavicular degeneration (31 patients, 15.7%), and lesions of the long head of the biceps tendon (30 patients, 15.2%). The most common type of impingement was subacromial impingement with a lesion of m. supraspinatus (41 patients, 51.9%).
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    • "Thus there is the likelihood of functional impairment of the rotator cuff. The rotator cuff muscles, besides assisting in the execution of complex movements, also contribute to the stabilization of the humerus in relation to the glenoid.26 The denervation of these structures can lead to chronic muscle atrophy. "
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    ABSTRACT: To study the shoulder of this group of patients using magnetic resonance imaging to detect clinical and subclinical disorders and establish a rehabilitation program. Nine patients with spinal cord injury followed in the Laboratory of Biomechanics and Rehabilitation of the Locomotive System at HC/UNICAMP were divided into two groups according to the presence of paraplegia and tetraplegia and were clinically assessed for correlation with the imaging exams. Normal results were found in 41% of the shoulders. Most common injuries were tendinopathy of the supraspinatus and acromioclavicular joint degeneration. Eighty percent of injured shoulders had combined lesions. A great variety of causes of shoulder pain was identified in paraplegic and tetraplegic subjects. Routine clinical assessment and imaging studies of the shoulder may contribute to the evolution of rehabilitation and reduction of pain and musculoskeletal disorders. Level of Evidence II, Development of Diagnostic Criteria on Consecutive Patients, With Universally Applied Reference "Gold" Standard.
    Acta Ortopédica Brasileira 03/2012; 20(5):291-6. DOI:10.1590/S1413-78522012000500009 · 0.19 Impact Factor
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    • "However, diagnosis based on magnetic resonance (MR) images is a preferred noninvasive alternative. Additionally , the impact of a supraspinatus tendon tear on the overall body of the muscle has prognostic value and is visible on MR images, but is not visible during arthroscopy [3] [4]. "
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    ABSTRACT: Supraspinatus muscle disorders are frequent and debilitating, resulting in pain and a limited range of shoulder motion. The gold standard for diagnosis involves an invasive surgical procedure. As part of a proposed clinical workflow for noninvasive computer-aided diagnosis (CAD) of the condition of the supraspinatus, we present a method to classify three-dimensional shapes of the muscle into relevant pathology groups, based on magnetic resonance (MR) images. We obtained MR images of the shoulder from 72 patients, separated into five pathology groups. The imaging protocol ensures that the supraspinatus is consistently oriented relative to the MR imaging plane for each scan. Next, we compute the Fourier coefficients of two-dimensional contours lying on parallel imaging planes and integrate the corresponding frequency components across all contours. To classify the shapes, we learn the Fourier coefficients that best distinguish the different classes. We show that our method leads to significant improvement when compared to previous work. We are able to distinguish between normal shapes and shapes that possess a pathology with an accuracy of almost 100%. Moreover, we can differentiate between the different pathology groups with an average accuracy of 86%. We confirm that analyzing the three-dimensional shape of the muscle has potential as a form of diagnosis reinforcement to assess the condition of the supraspinatus. Moreover, our proposed descriptor based on Fourier coefficients is able to distinguish the different pathology groups with accuracies higher than those obtained by previous work, indicating its potential application to support a system for CAD of the supraspinatus.
    Academic radiology 08/2010; 17(8):1040-9. DOI:10.1016/j.acra.2010.04.006 · 1.75 Impact Factor
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