The Rotator Interval – A Link Between Anatomy and Ultrasound

Tamborrini, Giorgio; Möller, Ingrid; Bong, David; Miguel, Maribel; Marx, Christian; Müller, A; Müller‐Gerbl, Magdalena

doi:10.1055/s-0043-110473

Cited by 33 publications

(21 citation statements)

References 47 publications

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“…The only limiting factor is the presence of acromion, which compromises visualization of underneath soft tissue, for example, RC and RI. 34 Anatomical proximity of the anterior RC and RI presents with "superoanterior lesions." This distinct type of rotator cuff tear involves the subscapularis and anterior portion of the supraspinatus tendon and adjacent RI structures, for example, SGHL, CHL, and biceps tendon.…”

Section: Figmentioning

confidence: 99%

Revisiting the anatomy of rotator cuff relevant to rotator cuff injury

2020

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The rotator cuff is the prime stabilizer of the glenohumeral or shoulder joint. The last decade saw introduction of three components, namely, rotator cable, rotator crescent, and rotator interval of rotator cuff, which were being studied and published in dozen of literatures belonging to clinical specialties of orthopaedics and radiology. At times when these terms have helped the clinician to understand the biomechanics of the rotator cuff while improving the outcome of its repair, the knowledge of the same remains at large for the anatomists. The preoperative assessment of rotator cuff tear has helped surgeons to identify the structure and its functional deficits thereof. The rotator cable is a thick fibrous band that behaves like a suspension bridge. Tears of rotator cable result in partial loss of function or pseudoparalysis of shoulder joint. The rotator interval is a four-layered protective cover of ligaments and the capsule in the rotator cuff. The current knowledge of the rotator interval revealed that the minor underlying ligaments of the shoulder joint play a crucial role in maintaining the congruency of the rotator cuff. The rotator cuff injury is often misdiagnosed due to a lack of knowledge and identification of its recently reported components. This review intends to sensitize the anatomists to investigate further about rotator cuff anatomy and biomechanics of the shoulder joint.

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Section: Figmentioning

confidence: 99%

Revisiting the anatomy of rotator cuff relevant to rotator cuff injury

2020

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“…Several articles have reported that the morphology of the bicipital groove affects LBT disorders [7][8][9]; some anecdotal studies have not supported any correlation between intra-articular biceps tendon pathology and bicipital groove morphology [10]. Some authors have argued that the transverse ligament does not exist as a separate entity [5,11] but is considered as an extension of the subscapularis tendon and only contributes slightly to the stabilization of the LBT in the bicipital groove [12].…”

Section: Introductionmentioning

confidence: 99%

Definition, classification and morphometry of entrance of the bicipital groove and its associations with lesions of adjacent structures

Yuan

Zou

Zheng

et al. 2020

Preprint

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Background The definition of the entrance of the bicipital groove (EBG) is still unclear, and the relationships between the EBG and lesions of the long head of the biceps brachii tendon (LBT) and biceps pulley complex (BPC) have long been controversial. The purpose of this anatomic and imaging study was to define the EBG and to examine morphological parameters, classifications, and their relationships with lesions of the LBT and BPC. Methods One hundred thirteen unpaired intact dry humeri, 34 cadaveric shoulder specimens and 278 shoulder images were collected, measured, and classified based on morphological characteristics. Soft tissue and bony landmarks of the EBG were classified into different types. The relationships between the types and lesions of the LBT and BPC were analyzed through an anatomic and imaging study. Results Type II, type A and type i of the EBG and type b of the adjacent articular surface accounted for most of the dry humeri, cadavers, and images. Based on the EBG classification in the superoinferior image view, all of the subluxations and dislocations were classified as type B (61/120, 50.83%; χ2 = 16.55, P < 0.001), and most LBT and BPC lesions were type B (65/117, 55.56%; χ2 = 26.05, P < 0.001). LBTs were injured in (χ2=, P < 0.001) 83.56% of type B, 100% of type C, and 95.83% of type iii EBGs (χ2 = 135.69, 31.89, all P < 0.001). Similarly, BPCs were injured in 89.04% of type B and 93.10% of type C EBGs (χ2 = 153.14, P < 0.001), while BPCs were injured in 95.8% of type iii EBGs (χ2 = 33.79, P < 0.001). Conclusions The EBG is an anatomical concept worthy of clinical attention. Anatomical variations in the EBG correlated with lesions of the LBT and BPC. LBT and BPC lesions correlated with type B and C EBGs by imaging analysis.

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“…Both run intra‐articularly along the superolateral (lateral band) and inferomedial (medial band) aspects of the long head of biceps tendon. Under tension, the CHL reinforces the glenohumeral joint, especially in external rotation . The RI, which forms in the anterosuperior portion of the glenohumeral joint, is a space created by the coracoid process and the adjacent tendons of the subscapularis and supraspinatus muscle .…”

Section: Introductionmentioning

confidence: 99%

“…Under tension, the CHL reinforces the glenohumeral joint, especially in external rotation . The RI, which forms in the anterosuperior portion of the glenohumeral joint, is a space created by the coracoid process and the adjacent tendons of the subscapularis and supraspinatus muscle . The thickening of the CHL has been linked to GHIAC …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Accuracy of Two Ultrasound‐Guided Coracohumeral Ligament Injection Approaches: A Cadaveric Study

Majdalani

Boudier‐Revéret

Pape

et al. 2019

PM&R

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Background Glenohumeral idiopathic adhesive capsulitis is a common shoulder condition that hinders functionality. Addressing the pathology has been extensively researched. Ultrasound (US)‐guided injections have shown their efficacy. However, no study has been conducted to compare anatomical accuracy between different approaches in targeting the coracohumeral ligament (CHL). Objective To investigate whether US‐guided injection of the CHL can be performed accurately using either the rotator interval (RI) or the coracoidal (CO) approach. Methods An experimental cadaveric case series. Setting Anatomy laboratory. Specimens Both shoulders of 13 Thiel‐embalmed cadavers. Interventions Three physiatrists each injected a 0.1 mL bolus of colored dye in both shoulders of each cadaver using either the RI or the CO approach under US guidance. Each cadaver received a total of six injections (three injections per shoulder). The accuracy of the injection was determined following shoulder dissection by an anatomist. Main Outcome Measure The accuracy of the US‐guided injection of the CHL. Results The RI approach yielded 36 accurate injections, giving it an accuracy of 100%. With the CO approach two injections were deemed inaccurate yielding an accuracy of 94%. There was no significant difference in accuracy between all operators. Conclusions US‐guided injection of the CHL can be performed accurately with both the RI and CO approaches. The RI approach was likely to be more accurate.

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The Rotator Interval – A Link Between Anatomy and Ultrasound

Cited by 33 publications

References 47 publications

Revisiting the anatomy of rotator cuff relevant to rotator cuff injury

Revisiting the anatomy of rotator cuff relevant to rotator cuff injury

Definition, classification and morphometry of entrance of the bicipital groove and its associations with lesions of adjacent structures

Accuracy of Two Ultrasound‐Guided Coracohumeral Ligament Injection Approaches: A Cadaveric Study

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