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Published in: Skeletal Radiology 12/2010

01-12-2010 | Scientific Article

Unusual variation of the rotator interval: insertional abnormality of the pectoralis minor tendon and absence of the coracohumeral ligament

Authors: Shin Jae Lee, Doo Hoe Ha, Sang Min Lee

Published in: Skeletal Radiology | Issue 12/2010

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Abstract

Objective

To evaluate the anomalous insertion of the pectoralis minor tendon with absence of the coracohumeral ligament on MR arthrography and to demonstrate the associated findings seen with this anatomical variation.

Materials and Methods

We retrospectively reviewed the 335 MR arthrograms of the shoulder joint (mean age 37.8 years) performed from March 2000 to February 2008. Images were evaluated with attention to anomalous insertion of the pectoralis minor tendon and the coracohumeral ligament.

Results

Anomalous insertion of the pectoralis minor tendon was demonstrated in 5 out of 335 shoulders (1.5%). The pectoralis minor tendons crossed over the coracoid process and attached directly to a glenohumeral joint capsule, and the coracohumeral ligament was absent in these 5 patients. In these patients, injected contrast material was noted to extend over the coracoid process along the course of the pectoralis minor tendon. Among 5 patients, 3 patients (60%) were diagnosed with SLAP (superior labrum anterior to posterior) lesions.

Conclusion

Anomalous insertion of the pectoralis minor tendon to the glenohumeral joint capsule and associated absence of the coracohumeral ligament is well demonstrated on MR arthrography. It is an unusual variant of the pectoralis minor muscle insertion, and may be a possible contributing factor in the development of a SLAP lesion.
Literature
1.
go back to reference Jost B, Koch PP, Gerber C. Anatomy and functional aspects of the rotator interval. J Shoulder Elbow Surg. 2000;9(4):336–341.CrossRefPubMed Jost B, Koch PP, Gerber C. Anatomy and functional aspects of the rotator interval. J Shoulder Elbow Surg. 2000;9(4):336–341.CrossRefPubMed
2.
go back to reference Werner A, Mueller T, Boehm D, Gohlke F. The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. A histoanatomic study. Am J Sports Med. 2000;28(1):28–31.PubMed Werner A, Mueller T, Boehm D, Gohlke F. The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. A histoanatomic study. Am J Sports Med. 2000;28(1):28–31.PubMed
3.
go back to reference Krief OP. MRI of the rotator interval capsule. Am J Roentgenol. 2005;184(5):1490–1494. Krief OP. MRI of the rotator interval capsule. Am J Roentgenol. 2005;184(5):1490–1494.
4.
go back to reference Gohlke F, Essigkrug B, Schmitz F. The pattern of collagen fiber bundles of the capsule of the glenohumeral joint. J Shoulder Elbow Surg. 1994;3:111–128.CrossRef Gohlke F, Essigkrug B, Schmitz F. The pattern of collagen fiber bundles of the capsule of the glenohumeral joint. J Shoulder Elbow Surg. 1994;3:111–128.CrossRef
5.
go back to reference Edelson JG, Taitz C, Grishkan A. The coracohumeral ligament. Anatomy of a substantial but neglected structure. J Bone Joint Surg Br. 1991;73(1):150–153.PubMed Edelson JG, Taitz C, Grishkan A. The coracohumeral ligament. Anatomy of a substantial but neglected structure. J Bone Joint Surg Br. 1991;73(1):150–153.PubMed
6.
go back to reference Tubbs RS, Oakes WJ, Salter EG. Unusual attachment of the pectoralis minor muscle. Clin Anat. 2005;18(4):302–304.CrossRefPubMed Tubbs RS, Oakes WJ, Salter EG. Unusual attachment of the pectoralis minor muscle. Clin Anat. 2005;18(4):302–304.CrossRefPubMed
7.
go back to reference Homsi C, Rodrigues MB, Silva JJ, Stump X, Morvan G. Anomalous insertion of the pectoralis minor muscle: ultrasound findings. J Radiol. 2003;84(9):1007–1011.PubMed Homsi C, Rodrigues MB, Silva JJ, Stump X, Morvan G. Anomalous insertion of the pectoralis minor muscle: ultrasound findings. J Radiol. 2003;84(9):1007–1011.PubMed
8.
go back to reference Morag Y, Jacobson JA, Shields G, et al. MR arthrography of rotator interval, long head of the biceps brachii, and biceps pulley of the shoulder. Radiology. 2005;235(1):21–30.CrossRefPubMed Morag Y, Jacobson JA, Shields G, et al. MR arthrography of rotator interval, long head of the biceps brachii, and biceps pulley of the shoulder. Radiology. 2005;235(1):21–30.CrossRefPubMed
9.
go back to reference Le Double AF. Traite des variations du systeme musculaire de l’homme. Schleicher Freres, 1897; 252–5. Le Double AF. Traite des variations du systeme musculaire de l’homme. Schleicher Freres, 1897; 252–5.
10.
go back to reference Rouviere H, Delmas A. Anatomie humaine descriptive, topographique et fonctionnelle. Tome III. Paris: Masson; 1991: 25–56. Rouviere H, Delmas A. Anatomie humaine descriptive, topographique et fonctionnelle. Tome III. Paris: Masson; 1991: 25–56.
11.
go back to reference Grant JCB. A method of anatomy. 2nd ed. Baltimore: Williams and Wilkins; 1940. Grant JCB. A method of anatomy. 2nd ed. Baltimore: Williams and Wilkins; 1940.
12.
go back to reference Yang HF, Tang KL, Chen W, et al. An anatomic and histologic study of the coracohumeral ligament. J Shoulder Elbow Surg. 2009;18:305–310.CrossRefPubMed Yang HF, Tang KL, Chen W, et al. An anatomic and histologic study of the coracohumeral ligament. J Shoulder Elbow Surg. 2009;18:305–310.CrossRefPubMed
13.
go back to reference Basmajian JV, Bazant FJ. Factors preventing downward dislocation of the adducted shoulder joint. An electromyographic and morphological study. J Bone Joint Surg Am 1959; 41-A:1182–1186.PubMed Basmajian JV, Bazant FJ. Factors preventing downward dislocation of the adducted shoulder joint. An electromyographic and morphological study. J Bone Joint Surg Am 1959; 41-A:1182–1186.PubMed
14.
go back to reference Ovesen J, Nielsen S. Experimental distal subluxation in the glenohumeral joint. Arch Orthop Trauma Surg. 1985;104(2):78–81.CrossRefPubMed Ovesen J, Nielsen S. Experimental distal subluxation in the glenohumeral joint. Arch Orthop Trauma Surg. 1985;104(2):78–81.CrossRefPubMed
15.
go back to reference Itoi E, Berglund LJ, Grabowski JJ, Naggar L, Morrey BF, An KN. Superior-inferior stability of the shoulder: role of the coracohumeral ligament and the rotator interval capsule. Mayo Clin Proc. 1998;73:508–515.CrossRefPubMed Itoi E, Berglund LJ, Grabowski JJ, Naggar L, Morrey BF, An KN. Superior-inferior stability of the shoulder: role of the coracohumeral ligament and the rotator interval capsule. Mayo Clin Proc. 1998;73:508–515.CrossRefPubMed
16.
go back to reference Bey MJ, Elders GJ, Huston LJ, Kuhn JE, Blasier RB, Soslowsky LJ. The mechanism of creation of superior labrum, anterior, and posterior lesions in a dynamic biomechanical model of the shoulder: the role of inferior subluxation. J Shoulder Elbow Surg. 1998;7(4):397–401.CrossRefPubMed Bey MJ, Elders GJ, Huston LJ, Kuhn JE, Blasier RB, Soslowsky LJ. The mechanism of creation of superior labrum, anterior, and posterior lesions in a dynamic biomechanical model of the shoulder: the role of inferior subluxation. J Shoulder Elbow Surg. 1998;7(4):397–401.CrossRefPubMed
17.
go back to reference McMahon PJ, Burkart A, Musahl V, Debski RE. Glenohumeral translations are increased after a type II superior labrum anterior-posterior lesion: a cadaveric study of severity of passive stabilizer injury. J Shoulder Elbow Surg. 2004;13(1):39–44.CrossRefPubMed McMahon PJ, Burkart A, Musahl V, Debski RE. Glenohumeral translations are increased after a type II superior labrum anterior-posterior lesion: a cadaveric study of severity of passive stabilizer injury. J Shoulder Elbow Surg. 2004;13(1):39–44.CrossRefPubMed
18.
go back to reference Kim TK, Queale WS, Cosgarea AJ, McFarland EG. Clinical features of the different types of SLAP lesions: an analysis of one hundred and thirty-nine cases. J Bone Joint Surg Am 2003; 85-A(1):66–71.PubMed Kim TK, Queale WS, Cosgarea AJ, McFarland EG. Clinical features of the different types of SLAP lesions: an analysis of one hundred and thirty-nine cases. J Bone Joint Surg Am 2003; 85-A(1):66–71.PubMed
Metadata
Title
Unusual variation of the rotator interval: insertional abnormality of the pectoralis minor tendon and absence of the coracohumeral ligament
Authors
Shin Jae Lee
Doo Hoe Ha
Sang Min Lee
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Skeletal Radiology / Issue 12/2010
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-010-0926-0

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