Shoulder MRI: the subacromial/subdeltoid bursa fat stripe in healthy and pathologic conditions

Vahlensieck, Martin; Resendes, M; Lang, Philipp; Genant, Harry K.

doi:10.1016/0720-048x(92)90092-n

Cited by 12 publications

(3 citation statements)

References 12 publications

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“…These are intratendinous changes of signal intensity on T1-, proton-and T2-weighted images, discontinuity of the tendons, intercalation of fluid within the tendon (recognised by signal increase on T2-weighted images compared with proton-weighted images), obliteration of the subdeltoid-subacromial (SD-SA) fatstripe and collection of joint fluid within the subacromial bursa. The incidence of artefacts is low, although misinterpretation may result from common variants and the magic angle effect [4,24]. The full extent of all tendons forming the rotator cuff including the osseous insertion and muscular transition can be exactly demonstrated as visual corridors as in sonography do not exist.…”

Section: Discussionmentioning

confidence: 97%

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Diagnosis of rotator cuff lesions: comparison of US and MRI on 38 joint specimens

et al. 1997

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IntroductionTreatment of patients with symptoms referable to the rotator cuff depends on location, extent and type of cuff injury. Magnetic resonance imaging and ultrasound are non-invasive imaging methods which are effective for detecting abnormalities of the rotator cuff and biceps tendon [1][2][3][4]. Although both methods are accepted in many routine diagnostic regimens, the results of various studies show a broad range of sensitivity and specificity [5][6][7][8][9][10][11][12]. Statements concerning value and reliability of US and MRI in diagnosis of rotator cuff lesions range from enthusiastic acclaim to critical dismissal. Several factors influence the results of imaging methods in clinical practice. Apart from spatial and contrast resolution, the diagnostic accuracy is determined by the morphological criteria, experience of operator, examination technique, composition of patient collective and reference methods [1].A study on 38 cadaver specimens of shoulder joints was performed to assess the diagnostic value of MRI and US concerning reproducibility of normal joint structures, incidence of artefacts and detection of rotator cuff lesions. Examination on cadaver specimens permits direct comparison of both imaging methods under standardized conditions and verification of diagnostic findings by pathology.Abstract. An experimental study was performed on cadaveric joint specimens of the shoulder to determine the accuracy of US and MRI in diagnosis of abnormalities of the rotator cuff. The value of different morphological criteria was evaluated for discrimination of degeneration as well as partial and complete disruption. A total of 38 surgically exposed specimens of the shoulder joint were examined by US, MRI and pathological methods visualising the tendons of the rotator cuff in same axial and longitudinal orientations. The three imaging modalities were reviewed separately by experienced examiners, respectively, who were blind to other results. Evaluation criteria consisted of signs of shape (thinning, thickening, discontinuity and absence of rotator cuff) and structure (changes in echogenicity in US, increased signal intensity in MRI, tissue changes in pathology). Findings in US and MRI were finally compared with pathology to assess sensitivity and specificity. Pathology demonstrated 4 full-thickness tears, 6 partial-thickness tears, 16 cases with degeneration and 12 normal rotator cuffs. Ultrasound showed pathological signs in all abnormal cuffs, and one MRI report was false negative. Specificity was 67 % in US (4 of 12 cases were false positive) and 100 % in MRI (no abnormal findings in healthy tendons). Discrimination of different pathological disorders of the rotator cuff was reduced in both methods. Using US only 10 of 16 cases of degeneration, 2 of 6 partial tears and 3 of 4 complete tears were correctly defined. Using MRI 13 of 16 degenerations, 3 of 6 partial tears and 3 of 4 complete tears were detected. The MRI technique failed to visualise intratendinous calcifications in all 3 cases. We conclude t...

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Section: Discussionmentioning

confidence: 97%

“…Magnetic resonance imaging and ultrasound are non-invasive imaging methods which are effective for detecting abnormalities of the rotator cuff and biceps tendon [1][2][3][4]. Although both methods are accepted in many routine diagnostic regimens, the results of various studies show a broad range of sensitivity and specificity [5][6][7][8][9][10][11][12].…”

mentioning

confidence: 99%

Diagnosis of rotator cuff lesions: comparison of US and MRI on 38 joint specimens

et al. 1997

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“…Acute bursitis presents as a bursal effusion, with small amounts of fluid displacing the peribursal fat plane laterally, and larger effusions displacing the inferior margin of the peribursal fat plane lateral to the humeral shaft, resulting in a teardrop configuration. 6,7 Patients with acute subacromialsubdeltoid bursitis clinically present with pain and limited range of motion, particularly with abduction and overhead activities, in the absence of history of antecedent trauma. In contrast, chronic subacromial-subdeltoid bursitis presents with a more dull pain and tenderness at the greater tuberosity.…”

Section: Bursae and Synovial Recesses Subacromial-subdeltoid Bursamentioning

confidence: 99%

Imaging of Cysts and Bursae about the Shoulder

Meraj

Bencardino

Steinbach

2014

Semin Musculoskelet Radiol

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A variety of fluid and fluid-like containing structures can be seen on routine MR imaging of the shoulder including bursal effusions and cystic lesions often in association with rotator cuff tears and impingement. Given its high soft tissue contrast and multiplanar imaging capabilities, MR imaging is the modality of choice in quantifying size, confirming fluid composition, assessing anatomical relationship to the glenohumeral joint, and determining the presence/absence of accompanying intra-articular abnormalities in association with the bursal and juxta-articular cystic findings.

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Clinical anatomy of the subacromial and related shoulder bursae: A review of the literature

2017

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The subacromial bursa (SAB) is the main bursa of the shoulder. It facilitates normal movement and is also commonly involved in shoulder disorders. Other shoulder bursae have been described but their anatomy has not been well studied. Anatomical variation of shoulder bursae has been suggested and this has implications for clinical practice. This article reviews current knowledge of the normal anatomy of the SAB and related shoulder bursae. A systematic review of the English and German literature was conducted using databases and a hand search of reference lists focusing on the clinical anatomy of the SAB, coracobrachial and subcoracoid bursae and subtendinous bursa of subscapularis. Twenty-four original sources and 13 textbooks were identified. Fifteen studies described the general morphology of the shoulder bursae using cadaveric specimens, eight examined innervation, and one provided information about the blood supply of the SAB. The literature agrees that the SAB is consistent and well innervated with a lateral subdeltoid part and a variable subcoracoid portion. There is variability regarding the consistency, location, and communications of the coracobrachial and subcoracoid bursae and the superior part of the subtendinous bursa of subscapularis, and little information on their nerve and blood supply. Several bursae are present around the shoulder joint. Further research is warranted to understand the precise attachments, dimensions, and communications of the bursae, as well as their nerve and blood supply. This information will improve understanding of the clinical relevance of these bursae and inform appropriate assessment and treatment. Clin. Anat. 30:213-226, 2017. © 2017 Wiley Periodicals, Inc.

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Shoulder MRI: the subacromial/subdeltoid bursa fat stripe in healthy and pathologic conditions

Cited by 12 publications

References 12 publications

Diagnosis of rotator cuff lesions: comparison of US and MRI on 38 joint specimens

Diagnosis of rotator cuff lesions: comparison of US and MRI on 38 joint specimens

Imaging of Cysts and Bursae about the Shoulder

Clinical anatomy of the subacromial and related shoulder bursae: A review of the literature

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