Skip to main content
SpringerLink
Log in

MR arthrography of partial thickness tears of the undersurface of the rotator cuff: an arthroscopic correlation

  • Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

Partial thickness tears of the undersurface (articular surface) of the rotator cuff (RTC) have been recognized increasingly in recent years as a source of treatable shoulder pain in the athletic population. This study evaluated the efficacy of MR arthrography (MR-ARTH) in diagnosing these tears.

Design and patients

The study design was a retrospective review of medical records of patients who had presented with refractory shoulder complaints and subsequently undergone MR arthrography with multiple signal MRI sequences followed by shoulder arthroscopy. Of particular interest were patients who had oblique T1 fat suppression (COT1FS), coronal oblique T2 (COT2), and coronal oblique T2 fat suppression (COT2FS) images taken. Seventy-six subjects met the study criteria. Investigators examined the MR-ARTH images from these patients' charts while blinded as to arthroscopic results, clinical signs and symptoms.

Results

Based on COT1FS images, investigators identified nine subjects as having had full thickness tears, 28 as having had partial thickness tears of the undersurface of the rotator cuff (PRTC), and 39 as having had intact RTC. These results were compared to actual findings at arthroscopy: nine full thickness tears, 26 of 28 with PRTC and 34 of 39 intact. The sensitivity of MR-ARTH was 84%, with a positive predictive value of 93%. The overall accuracy was 91% (69/76). The specificity was 96%. That is, if a PRTC was not seen on the MR-ARTH images, it was very unlikely to exist. COT2 and COT2FS sequences failed to increase sensitivity and overall efficacy of MRI.

Conclusion

PRTC can be diagnosed accurately by MR-ARTH with gadopentatate contrast. A COT1FS sequence is recommended for evaluation when tears are suspected.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1. A
Fig. 2. A
Fig. 3. A
Fig. 4. A

Similar content being viewed by others

References

  1. Andrews JR, Broussard TS, Carson WG. Arthroscopy of the shoulder in the management of partial tears of the rotator cuff: A preliminary report. Arthroscopy 1985; 1:117–122.

    CAS  PubMed  Google Scholar 

  2. Payne LZ, Altchek DW, Craig EV, Warren RF. Arthroscopic treatment of partial rotator cuff tears in young athletes: a preliminary report. Am J Sports Med 1997; 25:299–305.

    CAS  PubMed  Google Scholar 

  3. Hodler J, Kursunoglu-Brahme S, Snyder SJ, et al. Rotator cuff disease: assessment with MR arthrography versus standard MR imaging in 36 patients with arthroscopic confirmation. Radiology 1992; 182:431–436.

    CAS  PubMed  Google Scholar 

  4. Karzel RP, Snyder SJ. Magnetic resonance arthrography of the shoulder: a new technique of shoulder imaging. Clin Sports Med 1993; 12:123–136.

    CAS  PubMed  Google Scholar 

  5. Nelson MC, Leather GP, Nirschl RP, Pettrone FA, Freedman MT. Evaluation of the painful shoulder. J Bone Joint Surg [Am] 1991; 73A:707–716.

    Google Scholar 

  6. Traughber PD, Goodwin TE. Shoulder MRI: arthroscopic correlation with emphasis on partial tears. J Comput Assist Tomogr 1992; 16:129–133.

    PubMed  Google Scholar 

  7. Tuite MJ, Yandow DR, DeSmet AA, Orwin JF, Quintana FA. Diagnosis of partial and complete rotator cuff tears using combined gradient echo and spin echo imaging. Skeletal Radiol 1994; 23:541–546.

    CAS  PubMed  Google Scholar 

  8. Wnorowski DC, Levinsohn M, Chamberlain BC, McAndrew DL. Magnetic resonance imaging assessment of the rotator cuff: Is it really accurate? Arthroscopy 1997; 13:710–719.

    CAS  PubMed  Google Scholar 

  9. Flannigan B, Kursunoglu-Brahme S, Snyder S, Karzel R, Del Pizzo W, Resnick D. MR arthrography of the shoulder: comparison with conventional MR imaging. Am J Roentgenol 1990; 155:829–832.

    CAS  Google Scholar 

  10. Palmer WE, Brown JH, Rosenthal DI. Rotator cuff: evaluation with fat-suppressed MR arthrography. Radiology 1993; 188:683–687.

    CAS  PubMed  Google Scholar 

  11. Zanetti M, Jost B, Lustenberger A, Hodler J. Clinical impact of MR arthrography of the shoulder. Acta Radiol 1999; 40:296–302.

    CAS  PubMed  Google Scholar 

  12. Walch G, Boileau P, Noel E, Donell ST. Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg 1991; 1:238–245.

    Google Scholar 

  13. Iannotti JP, Zlatkin MB, Esterhai JL, Kressel HY, Dalinka MK, Spindler KP. Magnetic resonance imaging of the shoulder. J Bone Joint Surg [Am] 1991; 3A:17–29.

    Google Scholar 

  14. Rafii M, Firooznia H, Sherman O et al. Rotator cuff lesions: signal patterns at MR imaging. Radiology 1990; 177:817–823.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Division of Sports Medicine, College of Medicine, University of Florida, 200-B SW 62nd Blvd., Gainesville, FL, 32607, USA

    Keith Meister

  2. Department of Orthopaedics, Division of Sports Medicine, College of Medicine, University of Florida, Gainesville, FL, 32610, USA

    Keith Meister, Peter A. Indelicato & William Fontenot

  3. Department of Radiology, College of Medicine, University of Florida, Gainesville, FL, 32610, USA

    Jim Thesing, William J. Montgomery & Steve Walczak

Authors
  1. Keith Meister
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jim Thesing
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. William J. Montgomery
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter A. Indelicato
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Steve Walczak
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. William Fontenot
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Keith Meister.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Meister, K., Thesing, J., Montgomery, W.J. et al. MR arthrography of partial thickness tears of the undersurface of the rotator cuff: an arthroscopic correlation. Skeletal Radiol 33, 136–141 (2004). https://doi.org/10.1007/s00256-003-0688-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-003-0688-z

Keywords

Search

Navigation