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Published in: Archives of Orthopaedic and Trauma Surgery 9/2003

01-11-2003 | Original Article

The significance of subacromial arthrography to verify partial bursal-side rotator cuff ruptures

Authors: Thomas L. Schneider, Rüdiger Schmidt-Wiethoff, Wolf Drescher, B. Fink, Joachim Schmidt, Hans J. Appell

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2003

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Abstract

Background

The purpose of this study was to verify a partial bursa-side rupture of the rotator cuff (RC) using different imaging techniques with special emphasis on the validity of a specific method of subacromial arthrography (SAA).

Methods

Patients (n=92, mean age 53.8 years) with a subacromial impingement syndrome underwent sonography, magnetic resonance imaging (MRI), and SAA. All diagnostic results were checked by subsequent arthroscopic surgery.

Results

Of 31 surgically verified ruptures, 17 showed a partial rupture located towards the bursa. These had been detected by MRI and ultrasound with a sensitivity of 64% and 41%, respectively, while SAA as a diagnostic tool yielded a sensitivity of 82%. In 14 cases of complete RC ruptures, all imaging techniques had a similar sensitivity of 86–93%.

Conclusion

It appears that SAA is an adequate and valid diagnostic tool for the detection of partial bursa-sided RC ruptures. Ultrasound and MRI showed a comparably lower sensitivity. It is therefore concluded that SAA has clear advantages in the diagnosis of this defect with the consequence that open surgical techniques can be avoided.
Literature
1.
go back to reference Bachmann G, Bauer T, Jürgensen I, Schwab J, Weimar B, Rau WS (1988) Diagnostic accuracy and therapeutic relevance of CT arthrography and MR arthrography of the shoulder joint. Fortschr Röntgenstr 168:149–156 Bachmann G, Bauer T, Jürgensen I, Schwab J, Weimar B, Rau WS (1988) Diagnostic accuracy and therapeutic relevance of CT arthrography and MR arthrography of the shoulder joint. Fortschr Röntgenstr 168:149–156
2.
go back to reference Bencardino JT, Beltran J, Rosenberg ZS, Rokito A, Schmahmann S, Mota J, Mellado JM, Zuckerman J, Cuomo F, Rose D (2000) Superior labrum anterior-posterior lesions: diagnosis with MR arthrography of the shoulder. Radiology 214:267–271PubMed Bencardino JT, Beltran J, Rosenberg ZS, Rokito A, Schmahmann S, Mota J, Mellado JM, Zuckerman J, Cuomo F, Rose D (2000) Superior labrum anterior-posterior lesions: diagnosis with MR arthrography of the shoulder. Radiology 214:267–271PubMed
3.
go back to reference Bigliani LU, Ticker JB, Flatow EL, Soslowsky LJ, Mow VC (1991) The relationship of acromial architecture to rotator cuff diseases. Clin Sports Med 10:823–838PubMed Bigliani LU, Ticker JB, Flatow EL, Soslowsky LJ, Mow VC (1991) The relationship of acromial architecture to rotator cuff diseases. Clin Sports Med 10:823–838PubMed
4.
go back to reference Blanchard TK, Constant CR, Bearcroft PW, Marshall TJ, Dixon AK (1998) Imaging of the rotator cuff: an arthrographic pitfall. Eur Radiol 8:817–819CrossRefPubMed Blanchard TK, Constant CR, Bearcroft PW, Marshall TJ, Dixon AK (1998) Imaging of the rotator cuff: an arthrographic pitfall. Eur Radiol 8:817–819CrossRefPubMed
5.
go back to reference Blanchard TK, Bearcroft PW, Maibaum A, Hazelman BL, Sharma S, Dixon AK (1999) Magnetic resonance imaging or arthrography for shoulder problems: a randomised study. Eur J Radiol 30:5–10CrossRefPubMed Blanchard TK, Bearcroft PW, Maibaum A, Hazelman BL, Sharma S, Dixon AK (1999) Magnetic resonance imaging or arthrography for shoulder problems: a randomised study. Eur J Radiol 30:5–10CrossRefPubMed
6.
go back to reference Craig EV (1984) The geyser sign and torn rotator cuff: clinical significance and pathomechanics. Clin Orthop 191:213–215PubMed Craig EV (1984) The geyser sign and torn rotator cuff: clinical significance and pathomechanics. Clin Orthop 191:213–215PubMed
7.
go back to reference Hahn OC, Schweitzer ME, Spetell CM (1999) Internal derangements of the shoulder: decision tree and cost-effectiveness analysis of conventional arthrography, conventional MRI, and MR arthrography. Skeletal Radiol 28:670–678CrossRefPubMed Hahn OC, Schweitzer ME, Spetell CM (1999) Internal derangements of the shoulder: decision tree and cost-effectiveness analysis of conventional arthrography, conventional MRI, and MR arthrography. Skeletal Radiol 28:670–678CrossRefPubMed
8.
go back to reference Kenn W, Hufnagel P, Müller T, Gohlke F, Böhm D, Kellner M, Hahn D (2000) Arthrography, ultrasound and MR imaging in the evaluation of the rotator cuff: a prospective study. Fortschr Röntgenstr 172:260–266 Kenn W, Hufnagel P, Müller T, Gohlke F, Böhm D, Kellner M, Hahn D (2000) Arthrography, ultrasound and MR imaging in the evaluation of the rotator cuff: a prospective study. Fortschr Röntgenstr 172:260–266
9.
go back to reference Nelson MC, Leather GP, Nirschl RP, Pettrone FA, Freedmann MT (1991) Evaluation of the painful shoulder. J Bone Joint Surg Am 73:707–716PubMed Nelson MC, Leather GP, Nirschl RP, Pettrone FA, Freedmann MT (1991) Evaluation of the painful shoulder. J Bone Joint Surg Am 73:707–716PubMed
10.
go back to reference Peh WCG (1998) Imaging the painful shoulder: an update. Hosp Med 59:783–787PubMed Peh WCG (1998) Imaging the painful shoulder: an update. Hosp Med 59:783–787PubMed
11.
go back to reference Rafii M, Firooznia H, Sherman O, Minkoff J, Weinreb G, Golimbu C (1990) Rotator cuff lesions: signal pattern at MR imaging. Radiology 177:817–823PubMed Rafii M, Firooznia H, Sherman O, Minkoff J, Weinreb G, Golimbu C (1990) Rotator cuff lesions: signal pattern at MR imaging. Radiology 177:817–823PubMed
12.
go back to reference Roberts CS, Galloway KP, Honaker TJ, Hulse G, Seligson D (1998) Sonography for the office screening of suspected rotator cuff tears: early experience of the orthopedic surgeon. Am J Orthop 27:503–506PubMed Roberts CS, Galloway KP, Honaker TJ, Hulse G, Seligson D (1998) Sonography for the office screening of suspected rotator cuff tears: early experience of the orthopedic surgeon. Am J Orthop 27:503–506PubMed
13.
go back to reference Robertson PL, Schweitzer ME, Mitchell DG (1995) Rotator cuff disorders: interobserver and intraobserver variation in diagnosis with MR imaging. Radiology 194:831–835PubMed Robertson PL, Schweitzer ME, Mitchell DG (1995) Rotator cuff disorders: interobserver and intraobserver variation in diagnosis with MR imaging. Radiology 194:831–835PubMed
14.
go back to reference Schneider T, Strauss JM, Glombitza M, Fink B, Rüther W (1996) The value of imaging procedures in the diagnosis of rotator cuff tears. J Shoulder Elbow Surg 5 (Suppl):32PubMed Schneider T, Strauss JM, Glombitza M, Fink B, Rüther W (1996) The value of imaging procedures in the diagnosis of rotator cuff tears. J Shoulder Elbow Surg 5 (Suppl):32PubMed
15.
go back to reference Snyder JS, Pachelli F, Del Pizzo W, Friedman MJ, Ferkel R, Pattee G (1991) Partial thickness rotator cuff tears: results of arthroscopic treatment. Arthroscopy 7:1–7PubMed Snyder JS, Pachelli F, Del Pizzo W, Friedman MJ, Ferkel R, Pattee G (1991) Partial thickness rotator cuff tears: results of arthroscopic treatment. Arthroscopy 7:1–7PubMed
16.
go back to reference Trauber PD, Goodwin TE (1992) Shoulder MRI: arthroscopic correlation with emphasis on partial tears. J Comput Assist Tomogr 16:129–133PubMed Trauber PD, Goodwin TE (1992) Shoulder MRI: arthroscopic correlation with emphasis on partial tears. J Comput Assist Tomogr 16:129–133PubMed
17.
go back to reference Wiener SN, Seitz WH Jr (1993) Sonography of the shoulder in patients with tears of the rotator cuff: accuracy and value for selecting surgical options. Am J Roentgenol 160:103–107 Wiener SN, Seitz WH Jr (1993) Sonography of the shoulder in patients with tears of the rotator cuff: accuracy and value for selecting surgical options. Am J Roentgenol 160:103–107
18.
go back to reference Yoneda M, Izawa K, Hirooka A, Hayashida K, Wakitani S (1998) Indicators of superior glenoid labral detachment on magnetic resonance imaging and computed tomography arthrography. J Shoulder Elbow Surg 7:2–12PubMed Yoneda M, Izawa K, Hirooka A, Hayashida K, Wakitani S (1998) Indicators of superior glenoid labral detachment on magnetic resonance imaging and computed tomography arthrography. J Shoulder Elbow Surg 7:2–12PubMed
Metadata
Title
The significance of subacromial arthrography to verify partial bursal-side rotator cuff ruptures
Authors
Thomas L. Schneider
Rüdiger Schmidt-Wiethoff
Wolf Drescher
B. Fink
Joachim Schmidt
Hans J. Appell
Publication date
01-11-2003
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 9/2003
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-003-0492-1

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