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European Radiology
Published in: European Radiology 5/2010

01-05-2010 | Musculoskeletal

Rotator cuff tears: should abduction and external rotation (ABER) positioning be performed before image acquisition? A CT arthrography study

Authors: Hubert Cochet, Stephane Couderc, Eric Pelé, Nicolas Amoretti, Marie-Hélène Moreau-Durieux, Olivier Hauger

Published in: European Radiology | Issue 5/2010

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Abstract

Objective

To evaluate the impact of abduction and external rotation (ABER) positioning performed before image acquisition on the assessment of rotator cuff tears.

Methods

Twenty-seven consecutive patients with clinically suspected rotator cuff tears underwent an initial CT arthrogram of the shoulder in neutral position, immediately followed by temporary ABER positioning, before a second CT acquisition in neutral position. Two observers blinded to potential pre-procedure ABER positioning independently analysed the randomly distributed images. Lesions were classified into partial-thickness (PT) and full-thickness (FT) tear subtypes. Lesion detection and measurements of pre- and post-ABER studies were compared.

Results

We found no influence of pre-test ABER positioning on FT detection or measurements. Every PT detected on pre-ABER study was also detected on post-ABER study (28/28 for reader 1, and 32/32 for reader 2). Seven and eight additional PT were found by readers 1 and 2, respectively, on post-ABER study. Lesion size increased after ABER in terms of area (P < 0.001 for both readers) and Ellman’s grade (P = 0.02 and 0.002 for reader 1 and 2, respectively).

Conclusion

ABER positioning before CT is associated with improved delineation of partial tears, a higher number of detected tears and modification of treatment planning.
Literature
1.
Van der Windt DA, Koes BW, de Jong BA, Bouter LM (1995) Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis 54:959–964CrossRefPubMed
2.
Millstein ES, Snyder SJ (2003) Arthroscopic management of partial, full-thickness, and complex rotator cuff tears: indications, techniques, and complications. Arthroscopy 19:189–199PubMed
3.
Yamanaka K, Fukuda H (1987) Pathological studies of the supraspinatus tendon with reference to incomplete thickness tear. In: Takagishi N (ed) The shoulder. Professional Postgraduate Services, Tokyo, pp 220–224
4.
Loehr JF, Uhthoff HK (1987) The pathogenesis of degenerative rotator cuff tears. Orthop Trans 11:237
5.
Fukuda H (2003) The management of partial-thickness tears of the rotator cuff. J Bone Joint Surg Br 85:3–11CrossRefPubMed
6.
Gartsman GM, Milne JC (1995) Articular surface partial-thickness rotator cuff tears. J Shoulder Elbow Surg 4:409–415CrossRefPubMed
7.
Fukuda H (2000) Partial-thickness rotator cuff tears: a modern view on Codman’s classic. J Shoulder Elbow Surg 9:163–168CrossRefPubMed
8.
Rudzki JR, Shaffer B (2008) New approaches to diagnosis and arthroscopic management of partial-thickness cuff tears. Clin Sports Med 27:691–717CrossRefPubMed
9.
Weber SC (1999) Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial-thickness rotator cuff tears. Arthroscopy 15:12–31CrossRef
10.
Cordasco FA, Backer M, Craig EV, Klein D, Warren RF (2002) The partial- thickness rotator cuff tear: is acromioplasty without repair sufficient? Am J Sports Med 30:257–260PubMed
11.
Mazzocca AD, Rincon LM, O’Connor RW et al (2008) Intra-articular partial-thickness rotator cuff tears: analysis of injured and repaired strain behavior. Am J Sports Med 36:110–116CrossRefPubMed
12.
Harryman DT 2nd, Mack LA, Wang KY, Jackins SE, Richardson ML, Matsen FA 3rd (1991) Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am 73:982–989PubMed
13.
Gazielly DF, Gleyze P, Montagnon C (1994) Functional and anatomical results after rotator cuff repair. Clin Orthop Relat Res 304:43–53PubMed
14.
Cole BJ, McCarty LP 3rd, Kang RW, Alford W, Lewis PB, Hayden JK (2007) Arthroscopic rotator cuff repair: Prospective functional outcome and repair integrity at minimum 2-year follow-up. J Shoulder Elbow Surg 16:579–585CrossRefPubMed
15.
Ellman H (1990) Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop 254:64–74PubMed
16.
Lecouvet FE, Simoni P, Koutaïssoff S, Vande Berg BC, Malghem J, Dubuc JE (2008) Multidetector spiral CT arthrography of the shoulder. Clinical applications and limits, with MR arthrography and arthroscopic correlations. Eur J Radiol 68:120–136CrossRefPubMed
17.
Charousset C, Bellaiche L, Duranthon LD, Grimberg J (2005) Accuracy of CT arthrography in the assessment of tears of the rotator cuff. J Bone Joint Surg Br 87-B:824–828CrossRef
18.
Tirman PF, Bost FW, Steinbach LS et al (1994) MR arthrographic depiction of tears of the rotator cuff: benefit of abduction and external rotation of the arm. Radiology 192:851–856PubMed
19.
Roger B, Skaf A, Lektrakul N, Yeh LR, Resnick D (1999) Imaging findings in the dominant shoulder of throwing athletes: comparison of radiography, arthrography, CT arthrography, and MR arthrography with arthroscopic correlation. AJR Am J Roentgenol 172:1371–1380PubMed
20.
Lee SY, Lee JK (2002) Horizontal component of partial-thickness tears of the rotator cuff: imaging characteristics and comparison of ABER view with oblique coronal view at MR arthrography—initial results. Radiology 224:470–476CrossRefPubMed
21.
Herold T, Bachthaler M, Hamer OW et al (2006) Indirect MR arthrography of the shoulder: use of abduction and external rotation to detect full- and partial-thickness tears of the supraspinatus tendon. Radiology 240:152–160CrossRefPubMed
22.
23.
Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310PubMed
24.
Seigel DG, Podgor MJ, Remaley NA (1992) Acceptable values of kappa for comparison of two groups. Am J Epidemiol 135:571–578PubMed
25.
Balich SM, Sheley RC, Brown TR, Sauser DD, Quinn SF (1997) MR imaging of the rotator cuff tendon: interobserver agreement and analysis of interpretive errors. Radiology 204:191–194PubMed
26.
Brenneke SL, Morgan CJ (1992) Evaluation of ultrasonography as a diagnostic technique in the assessment of rotator cuff tendon tears. Am J Sports Med 20:287–289CrossRefPubMed
27.
Nelson MC, Leather GP, Nirschl RP, Pettrone FA, Freedman MT (1991) Evaluation of the painful shoulder. A prospective comparison of magnetic resonance imaging, computerized tomographic arthrography, ultrasonography, and operative findings. J Bone Joint Surg Am 73:707–716PubMed
28.
Hodler J, Kursunoglu-Brahme S, Snyder SJ et al (1992) Rotator cuff disease: assessment with MR arthrography versus standard MR imaging in 36 patients with arthroscopic confirmation. Radiology 182:431–436PubMed
29.
Meister K, Thesing J, Montgomery WJ, Indelicato PA, Walczak S, Fontenot W (2004) MR arthrography of partial thickness tears of the undersurface of the rotator cuff: an arthroscopic correlation. Skeletal Radiol 33:136–141CrossRefPubMed
30.
Waldt S, Bruegel M, Mueller D et al (2007) Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation. Eur Radiol 17:491–498CrossRefPubMed
31.
Snyder SJ, Pachelli AF, Del Pizzo W, Friedman MJ, Ferkel RD, Pattee G (1991) Partial thickness rotator cuff tears: results of arthroscopic treatment. Arthroscopy 7:1–7PubMedCrossRef
32.
McConville OR, Iannotti JP (1999) Partial-thickness tears of the rotator cuff: evaluation and management. J Am Acad Orthop Surg 7:32–43PubMed
33.
Fukuda H, Hamada K, Nakajima T, Tomonaga A (1994) Pathology and pathogenesis of the intratendinous tearing of the rotator cuff viewed from en bloc histologic sections. Clin Orthop 304:60–67PubMed
34.
Walch G, Boileau P, Noel E, Donell ST (1992) Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg 1:238–245CrossRef
35.
Brenner ML, Morrison WB, Carrino JA et al (2000) Direct MR arthrography of the shoulder: is exercise prior to imaging beneficial or detrimental? Radiology 215:491–496PubMed
36.
37.
Worland RL, Lee D, Orozco CG et al (2003) Correlation of age, acromial morphology, and rotator cuff tear pathology diagnosed by ultrasound in asymptomatic patients. J South Orthop Assoc 12:23–26PubMed
38.
Litaker D, Pioro M, El Bilbeisi H, Brems J (2000) Returning to the bedside: using the history and physical examination to identify rotator cuff tears. J Am Geriatr Soc 48:1633–1637PubMed
Metadata
Title
Rotator cuff tears: should abduction and external rotation (ABER) positioning be performed before image acquisition? A CT arthrography study
Authors
Hubert Cochet
Stephane Couderc
Eric Pelé
Nicolas Amoretti
Marie-Hélène Moreau-Durieux
Olivier Hauger
Publication date
01-05-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 5/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1635-8

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