A Practical Approach to Imaging of the Shoulder With Emphasis on MR Imaging

Tirman, P. F. J.; Steinbach, Lynne S.; Belzer, John P.; Bost, F. W.

doi:10.1016/s0030-5898(05)70306-0

Cited by 31 publications

(8 citation statements)

References 88 publications

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“…MRI, an example of an advance in medical technology, provides enhanced anatomic imaging of musculoskeletal tissues and has been shown to be effective for diagnosing pathologic conditions of the shoulder. 4,5,7,9,15,17 Current techniques have the ability to demonstrate accurately even intrasubstance tears and tendon degeneration of the rotator cuff, which might be undetectable on arthroscopic inspection. 19 In addition, the results of MRI can significantly influence management decisions.…”

Section: Discussionmentioning

confidence: 99%

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Overutilization of shoulder magnetic resonance imaging as a diagnostic screening tool in patients with chronic shoulder pain

Bradley

Tung

Green

2005

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 99%

“…4,5,7,9,15,17 Multiple studies report sensitivities ranging from 91% to 100% and specificities ranging from 75% to 95% for rotator cuff tears (RCTs). 4,9,15 Similar results are reported for labral pathology and glenohumeral instability.…”

mentioning

confidence: 99%

Overutilization of shoulder magnetic resonance imaging as a diagnostic screening tool in patients with chronic shoulder pain

Bradley

Tung

Green

2005

Journal of Shoulder and Elbow Surgery

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“…ALTHOUGH INTRINSIC TENDON degeneration as a primary cause of rotator cuff rupture is still debated (1, 2), one of the factors often proposed to explain the etiology of shoulder impingement syndrome (SIS) and rotator cuff tear is the reduction of the acromiohumeral distance (AHD) during elevation of the arm (3–8). SIS is thought to reflect the painful compression of the supraspinatus tendon, the subacromial‐subdeltoid bursa, and/or the long head of the biceps tendon between the humeral head and the acromion (9). Neer (6) even postulated that as many as 95% of rotator cuff tears result from chronic impingement.…”

mentioning

confidence: 99%

Acromiohumeral distance in a seated position in persons with impingement syndrome

Hébert¹,

Moffet²,

Dufour³

et al. 2003

Magnetic Resonance Imaging

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Purpose:To compare the acromiohumeral distance (AHD) of both shoulders in subjects with a unilateral shoulder impingement syndrome (SIS) and healthy subjects in a seated position during free shoulder movements of large amplitude. Materials and Methods:Using a 0.5-Tesla SIGNA-SP/i™ open-configuration magnetic resonance imaging (MRI) system, the AHD was measured at several arm positions, in a standardized seated position. Results:In flexion (rest to 130°), the mean AHD of SIS varied from 8.3 to 2.8 mm, as compared to from 8.7 to 4.1 mm for asymptomatic contralateral shoulders. In abduction (rest to 110°), the AHD varied from 8.1 to 3.4 mm and from 8.8 to 4.6 mm for SIS and asymptomatic shoulders, respectively. The smallest AHD (P Ͻ .01) was observed at 110°. From 80°of arm elevation, the AHD was significantly smaller in impingement than in asymptomatic shoulders (P Ͻ .05). The AHD of asymptomatic shoulders did not differ from that of healthy subjects. In SIS, the AHD at rest was correlated with its reduction at all shoulder positions (r p ϭ 0.62-0.88), but was a poor predictor of the smallest AHD observed at 110°(flexion, R 2 ϭ 0.09; abduction, R 2 ϭ 0.08). Conclusion:In the critical arm elevation positions for impingement, AHD is discriminative for SIS, compared to asymptomatic shoulders and healthy ones. AHD at rest is a good indicator of the magnitude of its reduction in elevation, but not of the smallest AHD in arm elevation. ALTHOUGH INTRINSIC TENDON degeneration as a primary cause of rotator cuff rupture is still debated (1,2), one of the factors often proposed to explain the etiology of shoulder impingement syndrome (SIS) and rotator cuff tear is the reduction of the acromiohumeral distance (AHD) during elevation of the arm (3-8). SIS is thought to reflect the painful compression of the supraspinatus tendon, the subacromial-subdeltoid bursa, and/or the long head of the biceps tendon between the humeral head and the acromion (9). Neer (6) even postulated that as many as 95% of rotator cuff tears result from chronic impingement. Studies using scanning electron microscopy also support the idea that degenerative change of the cuff may be aggravated to the extent of a tear by friction and rubbing, irrespective of the initial cause of degeneration (10).In studies where plain conventional radiography was used, an AHD reduction to less than 6 mm is generally agreed to be pathological and indicative of a supraspinatus tendon rupture (12), and patients with an AHD of 7 mm or less, at rest, are likely to have multiple tendon tears (11) or a large cuff tear (5). With magnetic resonance imaging (MRI) in close-bore magnet gantries, which only allow for the evaluation of small shoulder motion and humeral rotations (13,14) in the supine position, evidence was found that the subacromial space of patients with SIS is significantly smaller than that in healthy persons (13). Other studies focused on detecting indirect signs such as osseous and soft-tissue abnormalities that may predispose to rotator cuff impingement (9,(15)(16...

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“…O mesmo ocorreu em relação à ressonância, com o aparecimento de seqüências melhores e mais rápidas e de novas bobinas de superfície. (15) .…”

Section: Discussionunclassified

“…Foi enfatizada a necessidade da realização e interpretação desse método por examinadores experientes e com aparelho adequado (15) .…”

Section: Nevertheless This Is Not Routinely Used In Many Centers Paunclassified

Diagnostic imaging of shoulder rotator cuff lesions

et al. 2002

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RESUMOForam avaliadas rupturas de espessura total nos tendões do manguito rotador do ombro por ultra-sonografia (US) e ressonância magnética (RM). A correlação cirúrgica ou artroscópica foi obtida em 25 casos. A US foi realizada em 22 pacientes e a RM em 17 ombros sintomáticos. Foram obtidas sensibilidade, especificidade e eficiência de 80%, 100% e 90,9% para a US e 90%, 100% e 94,12% para a RM, respectivamente. No subgrupo de pacientes submetidos a ambos os métodos diagnósticos (16 casos), a correlação estatística foi excelente (p< 0,001). Concluímos que US e RM são confiáveis na avaliação de rupturas de espessura total do manguito rotador. Quando a principal questão é a integridade do manguito rotador, a US pode ser considerada como o exame de investigação inicial, devido a sua disponibilidade e aos custos,na presença de radiologistas treinados e de equipamentos de alta resolução.Descritores: Ultra-som; ressonância magnética; manguito rotador INTRODUÇÃOO manguito, e particularmente o tendão supra-espinhal, deslizam pelo espaço entre a cabeça umeral e o arco córa-co-acromial (coracóide, ligamento córaco-acromial e acrô-mio) e podem ser atritados por estas estruturas durante a elevação do braço. Os microtraumas resultantes de movimentos repetitivos terminam por causar inflamação dos tendões que compõem o manguito e da bursa subacromialsubdeltóide sobrejacente. Ocorre um processo crônico degenerativo desses tendões, ao longo da vida. ARTIGO ORIGINALDiagnóstico por imagem nas rupturas do manguito rotador

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A Practical Approach to Imaging of the Shoulder With Emphasis on MR Imaging

Cited by 31 publications

References 88 publications

Overutilization of shoulder magnetic resonance imaging as a diagnostic screening tool in patients with chronic shoulder pain

Overutilization of shoulder magnetic resonance imaging as a diagnostic screening tool in patients with chronic shoulder pain

Acromiohumeral distance in a seated position in persons with impingement syndrome

Diagnostic imaging of shoulder rotator cuff lesions

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