Shoulder after surgery: MR imaging with surgical validation.

Owen, Ruaridh; Iannotti, J.P.; Kneeland, J. Bruce; Dalinka, Murray K.; Deren, J A; Oleaga, Laura

doi:10.1148/radiology.186.2.8421748

Cited by 123 publications

(89 citation statements)

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“…At the time of follow-up, all patients underwent MRI without arthrography on a 1.5-Tesla scanner (Siemens, Erlangen, Germany). Continuity or rupture of the tendon was assessed on coronal oblique T2-weighted and proton density-weighted images as well as short tau inversion recovery sequences according to established MRI criteria [21][22][23] .…”

Section: Imagingmentioning

confidence: 99%

“…who was blinded to clinical data and treatment randomly analyzed the initial MR arthrograms and the follow-up MRIs. The diagnosis of a full-thickness tear was made 23 when there was a fluid-equivalent signal or a visible gap of the supraspinatus tendon in at least one section of the T2-weighted or fat-suppressed sections. The size of the tear was assessed in millimeters in the sagittal and coronal planes with use of the scale available on the examinations on the MR screen.…”

Section: Imagingmentioning

confidence: 99%

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Evolution of Nonoperatively Treated Symptomatic Isolated Full-Thickness Supraspinatus Tears

Fucentese

Roll

Pfirrmann

et al. 2012

Journal of Bone and Joint Surgery

104

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BACKGROUND: The natural history of small, symptomatic rotator cuff tears is currently unclear. The purpose of the present study was to assess the clinical and structural outcomes for a consecutive series of patients with symptomatic, isolated full-thickness supraspinatus tears who had been offered rotator cuff repair but declined operative treatment. METHODS: In the study period, twenty-four patients with isolated full-thickness supraspinatus tears that had been diagnosed by means of magnetic resonance arthrography were offered rotator cuff repair and elected nonoperative treatment. The twenty men and four women had an average age of fifty-two years at the time of diagnosis. At a median of fortytwo months after the diagnosis, all patients were reexamined clinically according to the Constant and Murley scoring system and all shoulders underwent standard magnetic resonance imaging. RESULTS: At the time of follow-up, the mean subjective shoulder score was 74% of that for a normal shoulder and the mean Constant score was 75 points (relative Constant score, 86%). The mean rotator cuff tear size did not change significantly over time (95% confidence interval, 0.51 to 1.12). In two shoulders, the tear was no longer detectable on magnetic resonance imaging, in nine shoulders the tear was smaller than it had been at the time of the initial diagnosis, in nine patients the tear had not changed, and in six patients the tear had increased in size. There was a slight but significant progression of fatty muscle infiltration of the supraspinatus, but no patient had fatty infiltration beyond stage 2 at the time of the latest follow-up (95% confidence interval, 0% to 14%). CONCLUSIONS: In a consecutive series of patients who had been offered repair of an isolated, symptomatic supraspinatus tear, the refusal of operative treatment resulted in surprisingly high clinical patient satisfaction and no increase of the average size of the rotator cuff tear 3.5 years after the recommendation of operative repair. This study confirms that the size of small rotator cuff tears does not invariably increase over a limited period of time. Distinguishing tears that will increase in size from those that will not needs further study. Background: The natural history of small, symptomatic rotator cuff tears is currently unclear. The purpose of the present

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Section: Imagingmentioning

confidence: 99%

Section: Imagingmentioning

confidence: 99%

Evolution of Nonoperatively Treated Symptomatic Isolated Full-Thickness Supraspinatus Tears

Fucentese

Roll

Pfirrmann

et al. 2012

Journal of Bone and Joint Surgery

104

View full text Add to dashboard Cite

show abstract

“…35 Magnetic resonance imaging may have a tendency to overestimate the re-rupture rate. [36][37][38] Ultrasonography enables better evaluation of tendon thinning with greater accuracy in the assessment of the rotator cuff. 39,40 It is a dynamic evaluation and low-cost procedure.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Repair of Rotator Cuff Tears Using Absorbable Anchors with a Single-Row Technique

Russo

Cautiero

Giudice

et al. 2010

J Orthop Surg (Hong Kong)

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Purpose. To review outcomes of arthroscopic repair of rotator cuff tears using absorbable anchors with a single-row technique. Methods. 66 patients underwent arthroscopic repair for rotator cuff tears using absorbable anchors with a single-row technique. 51 of them aged 37 to 73 (mean, 57) years had been followed up for a mean of 29 (range, 20-37) months. The extent of the tear was classified as large, medium or small. Functional outcome was assessed using the Constant score. Constant scores and re-tear rates in 3 patient groups (classified by patient age and tear size) were compared. Results. Among the 66 patients, there were 24 large, 29 medium and 13 small cuff tears, and a total of 48, 37, and 18 anchors were used, respectively. Among the 51 patients, the median Constant score improved significantly after arthroscopy (30 vs. 73, p<0.0001

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“…As is done for the native shoulder, a surface coil should be used for maximum signal-tonoise ratio, and the imaging planes are similar to those of routine shoulder imaging, with axial, coronal oblique and sagittal oblique perspectives. For full-thickness (or complete) recurrent tears confirmed at surgery, Owen et al 4 reported 86% sensitivity and 92% specificity for MRI. However, although the subacromial space and rotator cuff are exquisitely evaluated in the native shoulder, the presence of susceptibility artefact after subacromial decompression and surgical repair might sometimes limit the evaluation of the rotator cuff, especially when modifications to the MRI protocol to reduce artefacts related to metal are not made.…”

Section: Imaging Approachmentioning

confidence: 99%

Complications of rotator cuff surgery—the role of post-operative imaging in patient care

Thakkar¹,

Thakkar²,

Srikumaran³

et al. 2014

BJR

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When pain or disability occurs after rotator cuff surgery, post-operative imaging is frequently performed. Post-operative complications and expected post-operative imaging findings in the shoulder are presented, with a focus on MRI, MR arthrography (MRA) and CT arthrography. MR and CT techniques are available to reduce image degradation secondary to surgical distortions of native anatomy and implant-related artefacts and to define complications after rotator cuff surgery. A useful approach to image the shoulder after surgery is the standard radiography, followed by MRI/MRA for patients with low "metal presence" and CT for patients who have a higher metal presence. However, for the assessment of patients who have undergone surgery for rotator cuff injuries, imaging findings should always be correlated with the clinical presentation because post-operative imaging abnormalities do not necessarily correlate with symptoms.The complexity of the anatomy and function of the rotator cuff makes the rotator cuff tendons vulnerable to considerable morbidity, often necessitating surgical intervention. Optimal management of rotator cuff abnormalities depends on a variety of factors, such as the presence and severity of an impingement, the degree of tendon damage and individual functional demands.1 The goals of rotator cuff surgery are to reduce pain, while simultaneously improving the function. The latter is accomplished by two main types of surgical procedures: (1) subacromial decompression surgery alone, typically with an acromioplasty and/or Mumford procedure (distal clavicular resection); and (2) repair of the rotator cuff tear (open or arthroscopic), which is almost always accompanied by a subacromial decompression.Post-operative imaging is performed when pain or disability occurs after a surgical procedure. Often, however, postoperative imaging is degraded by surgical distortions of the native anatomy and metallic artefacts related to implants. Nevertheless, it is imperative that clinicians have an accurate anatomical delineation of the operative site. It is also important for the radiologist to accurately diagnose complications that might occur after rotator cuff surgery to guide optimal treatment. Mansat et al 2 examined 40 articles reporting the results of open rotator cuff repairs and determined that the overall mean complication rate was 10.5%.The article addresses complications that occur after rotator cuff surgery and expected post-operative imaging findings, with a focus on MRI, MR arthrography (MRA) and CT arthrography (CTA). Because not all post-operative imaging findings result in disability or pain for the patient, we also emphasize our approach and experience regarding how best to define imaging abnormalities after rotator cuff surgery. IMAGING APPROACHA protocol for the imaging of the post-operative shoulder always begins with radiography of the shoulder. The purpose of the radiograph is not only to detect obvious osseous complications, but also to identify the type of surgical procedure performed ...

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Shoulder after surgery: MR imaging with surgical validation.

Cited by 123 publications

References 0 publications

Evolution of Nonoperatively Treated Symptomatic Isolated Full-Thickness Supraspinatus Tears

Evolution of Nonoperatively Treated Symptomatic Isolated Full-Thickness Supraspinatus Tears

Arthroscopic Repair of Rotator Cuff Tears Using Absorbable Anchors with a Single-Row Technique

Complications of rotator cuff surgery—the role of post-operative imaging in patient care

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