Evaluation Of Rotator Cuff Pathologies With MRI

Abstract

Shoulder joint with its multi directional movement, has the widest range of movements among all the joints in the body. Various muscles, tendons, ligaments around the joint make this type of movements possible with substantial stability to the joint of these multiple shoulder stabilizers, rotator cuff tendons play a crucial role. Among the various modalities of imaging, MRI provides a better depiction of the soft tissues of the shoulder joint. A descriptive MRI Study was undertaken in 50 patients admitted to Shri B.M Patil medical college and research center with suspected rotator cuff pathology. These patients were subjected to MR imaging at our Department from October 2013 to July 2015. All the MRI scans in this study were performed using 1.5 T MRI scanner (Phillips achieva). The purpose of this study was to describe the magnetic resonance imaging features of rotator cuff pathologies and to examine the influence of age, gender on rotator cuff pathologies among the study population. In this study population the age range was between 19 and 78 years with a mean of 52.10 + 2.08 and peak prevalence in the sixth and the seventh decade of life. The incidence of predisposing factors for rotator cuff tears also increase with age, as seen in the study type II &III acromions, acromioclavicular joint arthropathies, osteophytosis/spurs are common in the sixth and seventh decade of life. The gender distribution being almost equal with males constituting 54% and females constituting 46% in the study group. Pain and stiffness were commonest presenting complaints in the patients with rotator cuff abnormality of affected shoulder joint. The most commonly affected tendon was the supraspinatus tendon, followed by the subscapularis, infraspinatus and the least being teres minor tendon. XI About 42% of the patients showed presence of biceps tendon abnormality along with cuff abnormalities. Tendinopathies and partial tears were more common than the full thickness tear in this study. Among the partial tears articular surface tears are more common. Type II & III acromion, anterior downsloping acromion were more frequently encountered with abnormal supraspinatus tendon. A coracohumeral distance more than 10mm was more common with normal subscapularis tendon and this distance less than 6mm more frequent with abnormal tendon. An acromiohumeral distance more than 10mm was more common with normal supraspinatus tendon and this distance less than 7mm more frequent with an abnormal supraspinatus tendon. Presence of joint effusion and bursal are more common with abnormal cuff tendons and are good pointer for the presence of cuff lesions especially tears. MRI provides good delineation of the tendon status along with information regarding the adjacent structures. Thus provides good insight about the management plan more suitable for the patient.