The radiographic morphology of the greater tuberosity is associated with muscle degeneration in patients with symptomatic rotator cuff tears
Journal
Journal of Shoulder and Elbow Surgery
Journal Volume
28
Journal Issue
10
Start Page
1964-1970
ISSN
1058-2746
Date Issued
2019-10
Author(s)
Abstract
Background: Atrophy and fatty infiltration of the rotator cuff muscles portend poor findings in terms of postoperative function and the probability of retears. We assumed that sclerosis and spurs of the greater tuberosity (GT) on radiographs are associated with this rotator cuff muscle degeneration.
Methods: We retrospectively reviewed the preoperative radiographs and magnetic resonance (MR) images of 91 shoulders (average age of patients, 59.7 years; age range, 36-79 years) arthroscopically repaired between 2012 and 2016. The radiographic morphology of the GT was defined as normal, sclerotic, or spurring. Atrophy and fatty infiltration of the rotator cuff muscles were evaluated using the occupation ratio and Goutallier classification, respectively, via the MR images. Diagnoses of rotator cuff tears were made during arthroscopic shoulder surgery.
Results: Significant associations between the radiographic GT morphology and the severity of both supraspinatus muscle atrophy (P = .002) and infraspinatus muscle atrophy (P = .047) were found. The mean occupation ratios of both the sclerotic GT group and the spurring GT group were significantly reduced compared with the mean occupation ratio of the normal GT group. Patients with GT spurs were found to be prone to severe supraspinatus fatty degeneration (P = .020).
Conclusions: For patients with rotator cuff tears, the presence of GT spurs or sclerosis on radiographs predicted the occurrence of supraspinatus and infraspinatus muscle atrophy, as well as supraspinatus fatty infiltration, based on MR images. The clinical relevance is that MR imaging is suggested for patients with radiographic GT sclerosis or spurs to detect advanced rotator cuff lesions.
Subjects
Rotator cuff tear
fatty infiltration
greater tuberosity sclerosis
greater tuberosity spur
muscle atrophy
radiography
SDGs
Publisher
Elsevier BV
Type
journal article