Proximal Humeral Migration in Shoulders with Symptomatic and Asymptomatic Rotator Cuff Tears

Abstract

Proximal humeral migration correlates with rotator cuff tear size. Tears extending into the infraspinatus tendon are associated with greater humeral migration than is seen with isolated supraspinatus tears. Humeral migration resulting from symptomatic rotator cuff tears is greater than that resulting from asymptomatic tears. Additionally, there is a critical size for tendon tears resulting in humeral migration in painful shoulders. Although both pain and tear size influence glenohumeral kinematics in symptomatic shoulders, only tear size is an independent predictor of humeral migration.

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

“…Larger RC tear size (mean size 22.7 mm) was associated with pain in 1 low‐quality study 35. One study reported no association of RC tear size and symptoms, although in symptomatic tears >175 mm 2 , pain was correlated with tear size 30. Two high‐quality studies reported no association between RC tear size or location with pain, one of which was well‐adjusted 45, 48.…”

“…In total, 56 articles were included (41 cross‐sectional, 11 cohort, 4 case–control). Imaging modalities included 25 ultrasound 16, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 24 MRI 15, 16, 41, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 12 radiographs 27, 30, 49, 53, 55, 62, 65, 66, 67, 68, 69, 70, 3 bone scintigraphy 65, 71, 72, 2 PET 73, 74, and no computed tomography. Of these studies, 10 assessed associations with 2 imaging modalities (16, 27, 30, 41, …”

“…The mean (range) score was 48% 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67 for cohort, 41% 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41...…”

“…Sixteen studies evaluated the relationship of RC tears and symptoms (16, 21, 26, 29, 30, 32, 35, 45, 48, 49, 52, 54, 56, 58, 62, 72) (Tables 1, 2, and 3). Nine evaluated the relationship with shoulder pain 16, 21, 30, 32, 35, 45, 49, 52, 72, 4 with shoulder disability 16, 29, 45, 54, and 8 studies with symptoms using a composite pain and function score 26, 29, 32, 48, 49, 54, 56, 58.…”

“…Nine evaluated the relationship with shoulder pain 16, 21, 30, 32, 35, 45, 49, 52, 72, 4 with shoulder disability 16, 29, 45, 54, and 8 studies with symptoms using a composite pain and function score 26, 29, 32, 48, 49, 54, 56, 58.…”