Magnetic resonance imaging diagnosis of rotator cuff tears in subacromial impingement syndrome: A retrospective analysis of large series of cases from a single center

Abstract

Background: The most frequent painful shoulder diagnosis is subacromial impingement syndrome. It is important to establish valid diagnostic methods for these patients to potentially improve the management and treatment of this syndrome. Magnetic resonance imaging (MRI) is an excellent modality for imaging of soft tissues of the shoulder joint considering a possibility of multiplanar image acquisition and noninvasive nature of the study. The purpose of this study was to evaluate the prevalence of partial and complete rotator cuff tears in magnetic resonance images of patients with subacromial impingement syndrome and to review the literature on the causes and classification of rotator cuff tears. Materials and Methods: After obtaining institutional ethical committee approval, we retrospectively analyzed the results of 200 shoulder MRI examinations with rotator cuff tears performed in 78 women and 122 men in the department of radiology and diagnostic imaging at a tertiary care hospital between April 2014 and December 2018. Examinations were performed using GE Brivo 1.5T device, including spin echo and gradient echo sequences with T1, T2, and proton-density-weighted as well as fat-saturation sequences in axial, coronal, and sagittal oblique planes. Results: Partial and complete supraspinatus tendon tears were the most frequently reported injuries, with a minority of injuries showing complete tear of subscapularis. Among the 200 patients in the study population, 195 patients suffered from shoulder pain, including 117 patients with a history of trauma. There were 59% men and 41% women among patients with shoulder pain. Posttraumatic shoulder pain was predominantly reported by men, whereas women comprised a larger group of patients with shoulder pain not preceded by injury. Subacromial impingement commonly involved supraspinatus tendon, and supraspinatus tear was the most commonly identified pathology. Subscapularis muscle and infraspinatus tendon tears were less common. Isolated involvement and complete tear most often involved supraspinatus muscle tendon followed by infraspinatus and least often involved subscapularis tendons. Conclusion: Rotator cuff disorders are among the most common causes of shoulder pain and disability encountered, and subacromial impingement syndrome in particular is the most common disorder. Isolated supraspinatus tendon injury or complete tearing is most frequent, rather than in conjunction with injuries to other rotator cuff tendons. Isolated complete tears of infraspinatus and subscapular muscle tendons were rarely encountered in our study.

Keywords

• magnetic resonance imaging
• shoulder pain
• subacromial impingement syndrome