Current Imaging of the Rotator Cuff

Abstract

Rotator cuff pathology is a common cause of shoulder pain, and imaging plays a major role in the management of shoulder problems. General radiography may be useful as an initial screening test particularly in trauma and arthritis. Musculoskeletal ultrasound and magnetic resonance imaging are the most suitable modalities for the investigation of the rotator cuff, having high sensitivities and specificities for full-thickness tears. Musculoskeletal ultrasound and magnetic resonance imaging are less accurate in the detection of partial-thickness tears with greater observer variability. This article reviews the normal and pathologic imaging features of the rotator cuff and highlights the potential usefulness and limitations of various imaging modalities in the assessment of the tendon and the potential impact of imaging findings on clinical patient care.

Shoulder Conditions

“…5,7 MRI remains the gold standard in the radiographic assessment of rotator cuff tears. 32 Radiograph or computed tomography arthrogram is appropriate if there is a contraindication to an MRI. Contrast MRI is not necessary for making the diagnosis of a rotator cuff tear.…”

Rotator cuff tears: Review of epidemiology, clinical assessment and operative treatment

“…Whilst useful in assessing trauma and arthritis, its role in rotator cuff assessment is limited due to lack of soft tissue contrast. 65 Plain films are usually normal in acute RTCs. Chronic RTCs can cause superior subluxation of the humerus and narrowing of the acromiohumeral interval to less than 7 mm (Figure 1); reversal of the normal inferior acromial convexity from atypical contact between the humeral head and the acromial undersurface; cystic change with sclerosis of the acromion, humeral head, and the greater tuberosity from recurrent trauma; and notching of the superior aspect of the humeral neck 66,67 may be seen.…”

Common sports-related shoulder injuries

“…They may get symptoms from reaching behind the back and with lifting movements. Night pain can also be a feature, and weakness can develop in late stages (Factor & Dale, 2014).…”

“…MRI can be used to evaluate both soft tissue and bony injuries in detail. It is unclear whether MRI is more accurate at detecting rotator cuff tendinopathy compared with USS, but both are equally effective in detecting partial or full thickness tears (Gazzola & Bleakney, 2011). Labral injuries can be detected with MRI, but a meta-analysis revealed that magnetic resonance arthrography is superior to MRI (Smith, Hilton, Toms, Donell, & Hing, 2011).…”