MRI of symptomatic and asymptomatic full-thickness rotator cuff tears. A comparison of findings in 100 subjects

Stefan Moosmayer, Rana Tariq, Morten G Stiris, Hans-Jørgen Smith, Stefan Moosmayer, Rana Tariq, Morten G Stiris, Hans-Jørgen Smith

Abstract

Background and purpose: Why some full-thickness rotator cuff tears are symptomatic and others are asymptomatic is not understood. By comparing MRI findings in symptomatic and asymptomatic tears, we wanted to identify any tear characteristics that differed between groups.

Patients and methods: 50 subjects with asymptomatic and 50 subjects with symptomatic full-thickness tears were examined by MRI. Tear characteristics including tear size, tear location, the condition of the long head of the biceps, atrophy, and fatty degeneration of the muscles were compared between groups.

Results: Single factor logistic regression analysis showed that there were statistically significant associations between symptoms and tear size exceeding 3 cm in the medial-lateral plane, positive tangent sign, and fatty degeneration exceeding grade 1 of the supraspinatus and infraspinatus muscles.

Interpretation: We found associations between the symptomatic status of a rotator cuff tear and MRI-derived tear characteristics. The causal relationships are unclear.

References

    1. Bryant L, Shnier R, Bryant C, Murrell GA. A comparison of clinical estimation, ultrasonography, magnetic resonance imaging and arthroscopy in determining the size of rotator cuff tears. J Shoulder Elbow Surg. 2002;11:219–24.
    1. Burkhart SS. Arthroscopic debridement and decompression for selected rotator cuff tears. Orthop Clin. 1993;24:111–23.
    1. Cotton RE, Rideout DF. Tears of the humeral rotator cuff. J Bone Joint Surg (Br) 1964;46:314–28.
    1. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: Assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg. 1999;8:599–605.
    1. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuffruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop. 1994;((304)):78–83.
    1. Hirano Y, Sashi R, Izumi J, Itoi E, Watarai J. Comparison of the findings on indirect MR arthrography in patients with rotator cuff tears with and without symptoms. Radiat Med. 2006;24:23–7.
    1. Ianotti JP, Zlatkin MB, Esterhai JL, Kressel HY, Dalinka MK, Spindler KP. Magnetic resonance imaging of the shoulder. Sensitivity, specificity. and predictive value. J Bone Joint Surg (Am) 1991;73:17–29.
    1. Kedgley AE, Mackenzie GA, Ferreira LM, Johnson JA, Faber KJ. In vitro kinematics of the shoulder following rotator cuff injury. Clin Biomech. 2007;22:1068–73.
    1. Kluger R, Mayrhofer R, Kröner A, Pabinger C, Pärtan G, Hruby W, Engel A. Sonographic versus magnetic resonance arthrographic evaluation of full-thickness rotator cuff tears in millimeters. J Shoulder Elbow Surg. 2003;12:110–6.
    1. Moosmayer S, Heir S, Smith HJ. Sonography of the rotator cuff in painful shoulders performed without knowledge of clinical information: Results from 58 sonographic examinations with surgical correlation. J Clin Ultrasound. 2007;35:20–6.
    1. Moosmayer S, Smith HJ, Tariq R, Larmo A. Prevalence and characteristics of asymptomatic tears of the rotator cuff. An ultrasonographic and clinical study. J Bone Joint Surg (Br) 2009;91:196–200.
    1. Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S. Tears of the rotator cuff of the shoulder associated with pathological changes of the acromion. A study in cadavera. J Bone Joint Surg (Am) 1988;70:1224–30.
    1. Richards RR, Kai-Nan A, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG, Iannotti JP, Mow VC, Sidles JA, Zuckerman JD. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg. 1994;3:347–52.
    1. Sallay PI, Reed L. The measurement of normative American shoulder and elbow surgeons scores. J Shoulder Elbow Surg. 2003;12:622–7.
    1. Schibany N, Zehetgruber H, Kainberger F, Wurnig C, Ba-Ssalamah A, Herneth AM, Lang T, Gruber D, Breitenseher MJ. Rotator cuff tears in asymptomatic individuals: a clinical and ultrasonographic screening study. Eur J Radiol. 2004;51:263–8.
    1. Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg (Am) 1995;77:10–5.
    1. Szabó I, Boileau P, Walch G. The proximal biceps as a pain generator and results of tenotomy. Sports Med Arthrosc Rev. 2008;16:180–6.
    1. Teefey SA, Rubin DA, Middleton WD, Hildebolt CF, Leibold RA, Yamaguchi K. Detection and quantification of rotator cuff tears. Comparison of ultrasonographic, magnetic resonance imaging, and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg (Am) 2004;86:708–11.
    1. Tempelhof S, Rupp S, Seil R. Age-related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg. 1999;8:296–9.
    1. Thomas M, Dieball O, Busse M. Normalwerte der Schulterkraft in Abhängigkeit von Alter und Geschlecht – Vergleich zum Constant-, UCLA-, ASES-Score und SF-36 Fragebogen. Z Orthop. 2003;141:160–70.
    1. Thomazeau H, Rolland Y, Lucas C, Duval JM, Langlais F. Atrophy of the supraspinatus belly. Assessment by MRI in 55 patients with rotator cuff pathology. Acta Orthop Scand. 1996;67:264–8.
    1. Thompson WO, Debski RE, Boardman ND, III, Taskiran E, Warner JJ, Fu FH, Woo SL. A biomechanical analysis of rotator cuff deficiency in a cadaveric model. Am J Sports Med. 1996;24:286–92.
    1. Worland RL, Lee D, Orozco CG, SozaRex F, Keenan J. Correlation of age, acromial morphology, and rotator cuff tear pathology diagnosed by ultrasound in asymptomatic patients. J South Orthop Assoc. 2003;12:23–6.
    1. Yamaguchi K, Sher JS, Andersen WK, Garretson R, Uribe JW, Hechtman K, Neviaser RJ. Glenohumeral motion in patients with rotator cuff tears: A comparison of asymptomatic and symptomatic shoulders. J Shoulder Elbow Surg. 2000;9:6–11.
    1. Yamaguchi K, Tetro AM, Blam O, Evanoff BA, Teefey SA, Middleton WD. Natural history of asymptomatic rotator cuff tears: A longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg. 2001;10:199–203.
    1. Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg (Am) 2006;88:1699–704.
    1. Zanetti M, Gerber C, Hodler J. Quantitative assessment of the muscles of the rotator cuff with magnetic resonance imaging. Invest Radiol. 1998a;33:163–70.
    1. Zanetti M, Weishaupt D, Gerber C, Hodler J. Tendinopathy and rupture of the tendon of the long head of the biceps brachii muscle: Evaluation with MR arthrography. AJR. 1998b;170:1557–61.

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