MR imaging of rotator cuff injury: What the clinician needs to know
ABSTRACT 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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ABSTRACT: Rotator cuff tears are a common source of shoulder pain and disability. Even after surgical repair, some patients continue to have reduced function and progression of fatty degeneration. Because patients with chronic cuff tears often experience muscle shortening, it is possible that repairing the tendon to its anatomic footprint induces a stretch-induced muscle injury that could contribute to failures of the repair and perhaps ongoing pain.Clinical Orthopaedics and Related Research 08/2014; 473(1). DOI:10.1007/s11999-014-3860-y · 2.88 Impact Factor
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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%).
Article: MDCT Arthrography of the Shoulder[Show abstract] [Hide abstract]
ABSTRACT: High-resolution multidetector computed tomography (MDCT) arthrography of the shoulder can diagnose internal derangement of the glenohumeral joints including abnormalities of the rotator cuff, glenoid labrum, and articular cartilage. Isotropic data sets and postprocessing techniques enable interactive three-dimensional image analysis that is capable of reducing artifacts for metal implants. In this article, we review the indications for MDCT arthrography of the shoulder, highlight techniques and important features of the MDCT acquisition, and review normal and abnormal MDCT arthrography appearances of the glenohumeral joint.Seminars in musculoskeletal radiology 09/2014; 18(4):343-51. DOI:10.1055/s-0034-1384824 · 0.95 Impact Factor