Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Rotator Cuff”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMedDate not supplied

Rotator cuff: evaluation with US and MR imaging.

Magnetic resonance (MR) and ultrasound (US) imaging are currently touted for assessment of rotator cuff disease. Optimum clinical imaging techniques include use of (a) a 1.5-T MR imaging unit with small planar coils, proton-density-weighted and T2-weighted fast spin-echo sequences, and 10-12-cm fields of view (yielding 400-470 x 500-625-microm in-plane spatial resolution) and (b) a state-of-the-art commercial US unit with insonation frequencies of 9-13 MHz (yielding 200-400-microm axial and lateral resolution). Proper diagnosis requires familiarity with normal anatomic characteristics and imaging pitfalls. Care must be taken to avoid sonographic tendon anisotropy and MR imaging magic angle effects, which can be misinterpreted as rotator cuff tear. At MR imaging, a complete cuff tear typically appears as either a hyperintense defect or a tendinous avulsion that extends from the bursal to the articular side of the cuff; a partial cuff tear typically appears as a focal hyperintense region that contacts only one surface of the cuff. Complete and partial tears manifest with a wide spectrum of findings at US. MR imaging and US are effective for evaluating rotator cuff injuries, with high reported accuracies for detection of complete tears but more disparate results for detection of partial tears.

Artifacts↗
PubMed2004

Sonography of the rotator cuff: analysis of interobserver variability.

OBJECTIVE: The purpose of our study was to determine the interobserver variability in the sonographic evaluation of the rotator cuff. SUBJECTS AND METHODS: Two radiologists independently scanned 61 patients with shoulder pain. Each radiologist categorized the rotator cuff as normal, partially torn, or fully torn. When a tear was present, the tendons involved were specified. All diagnoses were made prospectively without knowledge of the findings of the other radiologist. RESULTS: The radiologists were in full agreement in the categorization of 92% (56/61) of the patients. In four of the five discrepant cases, the disagreement was whether there was a full-thickness or a partial-thickness tear. The radiologists were in agreement concerning which tendons were involved in 80% (41/51) of the patients in whom a tear was detected by both observers. In all 10 discrepant cases, the disagreement was whether a tear involved both the supraspinatus and infraspinatus tendons or was isolated to one or the other of these tendons. CONCLUSION: The level of interobserver variability in the sonographic detection and characterization of rotator cuff tears is low.

Adolescent↗
PubMed1981

[Surgical treatment of the rotator cuff rupture (author's transl)].

Ruptures of the rotator cuff are more frequent than generally assumed. Out of 25 patients with ruptures of the rotator cuff treated surgically, 17 were seen at follow-up investigations at least 6 months later. The procedure was successful in most cases. Should severe pains persist despite regular conservative treatment for 6--8 weeks, disturbing night rest of sports and working performance, and has the rupture been demonstrated by arthrography, surgical reconstruction should not be delayed as partial shoulder immobility diminishes postoperative results considerably. Long-term follow-up physiotherapy is a prerequisite for a lasting success.

Adult↗
PubMed2006

Glenohumeral interposition of a torn rotator cuff in a young motorcyclist.

This report describes the rare case of a traumatic rotator cuff tear in a young patient which led to a pseudo-paralyzed shoulder by interposition of the tendon stump into the glenohumeral joint. The patient underwent an open rotator cuff repair and regained an almost normal shoulder function after 12 weeks. A review of the literature is presented.

Accidents, Traffic↗
PubMed2004

Results of arthroscopic acromioplasty for chronic rotator cuff lesion.

The influence of acromioplasty in long standing rotator cuff deficiency with intractable pain was retrospectively evaluated in a consecutive series of 13 patients who were followed for a mean period of 19 months (range, 12 to 42 months) after arthroscopic acromioplasty. The Constant score improved from 59.3 (range, 39.9 to 90.3) preoperatively to 98.7 (69.1 to 122.7) postoperatively. Pain and motion improved significantly whereas strength did not improve. Arthroscopic acromioplasty in painful chronic rotator cuff avulsion was found to be an effective means to control pain and improve motion; it can be recommended when conservative treatment has failed.

Acromion↗
PubMedDate not supplied

Reconstruction of large rotator cuff tendon defects with porcine small intestinal submucosa in an animal model.

Large rotator cuff tears represent a challenging problem. The purpose of our study was to evaluate the small intestinal submucosa (SIS) extracellular matrix in reconstruction of such defects in an animal model. Forty rats were equally divided into an SIS group (reconstruction of a large supraspinatus tendon defect by use of the SIS) and a defect group (no repair). The operative and contralateral normal shoulders underwent histologic evaluation and biomechanical testing at 6 and 16 weeks. Neovascularization and fibroblastic ingrowth were present in SIS-regenerated tendons, which had an ultimate force to failure that was 78% of normal at 16 weeks. This was higher than in the defect group, which demonstrated an ultimate force to failure that was 34% of normal (P = .008). The ultimate force to failure of the SIS-regenerated tendons approached that of the normal tendon at 16 weeks. The SIS extracellular matrix served as a scaffold promoting host tissue ingrowth and appears promising in the management of large rotator cuff defects in a rat model. However, human beings sustain tears at the bone-tendon interface and demonstrate decreased healing potential relative to rats. Therefore, the findings of this preliminary study should not be extrapolated to human beings without further investigation.

Animals↗
PubMed2000

Management of chronic deep infection following rotator cuff repair.

BACKGROUND: Deep infection of the shoulder following rotator cuff repair is uncommon. There are few reports in the literature regarding the management of such infections. METHODS: We retrospectively reviewed the charts of thirteen patients and recorded the demographic data, clinical and laboratory findings, risk factors, bacteriological findings, and results of surgical management. RESULTS: The average age of the patients was 63.7 years. The interval between the rotator cuff repair and the referral because of infection averaged 9.7 months. An average of 2.4 procedures were performed prior to referral because of infection, and an average of 2.1 procedures were performed at our institution. All patients had pain on presentation, and most had a restricted range of motion. Most patients were afebrile and did not have an elevated white blood-cell count but did have an elevated erythrocyte sedimentation rate. The most common organisms were Staphylococcus epidermidis, Staphylococcus aureus, and Propionibacterium species. At an average of 3.1 years, all patients were free of infection. Using the Simple Shoulder Test, eight patients stated that the shoulder was comfortable with the arm at rest by the side, they could sleep comfortably, and they were able to perform activities below shoulder level. However, most patients had poor overhead function. CONCLUSIONS: Extensive soft-tissue loss or destruction is associated with a worse prognosis. Extensive débridement, often combined with a muscle transfer, and administration of the appropriate antibiotics controlled the infection, although most patients were left with a substantial deficit in overhead function of the shoulder.

Adult↗
PubMed1999

MR imaging for traumatic tears of the rotator cuff: high prevalence of greater tuberosity fractures and subscapularis tendon tears.

OBJECTIVE: The purpose of this study was to determine whether occult bony injuries or other characteristic MR abnormalities are frequent in patients suspected of having traumatic tears of the rotator cuff. SUBJECTS AND METHODS: MR arthrography of the shoulder was performed in 24 consecutive patients with suspected traumatic tears of the rotator cuff. MR findings were analyzed with regard to abnormalities of the supraspinatus, infraspinatus, and subscapularis tendons; and the humeral head. A comparison group of 24 consecutive patients with symptoms of nontraumatic tears of the rotator cuff was included in the investigation. RESULTS: Radiographically occult fractures of the greater tuberosity were found in nine (38%) of 24 patients with clinically suspected traumatic tears of the rotator cuff (seven of which occurred in patients <40 years old). Nine partial-thickness and five full-thickness supraspinatus tears were found in the trauma group. In the comparison group, the corresponding numbers were 13 and 10, respectively. Seven partial lesions of the cranial border of the subscapularis and six complete subscapularis tears (all six in patients >40 years old) were found in the trauma group (nine and one in the comparison group). CONCLUSION: Occult greater tuberosity fractures and complete subscapularis tears are commonly seen on MR images in patients suspected of having traumatic tears of the rotator cuff. Greater tuberosity fractures should be looked for specifically in patients younger than 40 years, and subscapularis tears should be looked for specifically in patients older than 40 years.

Adult↗
PubMedDate not supplied

Roentgenographic assessment of acromial morphologic condition in rotator cuff impingement syndrome.

Patients with an isolated diagnosis of rotator cuff impingement syndrome were prospectively entered into the study. Each of the 23 subjects was refractory to conservative therapy, had preoperative roentgenograms, and underwent an open acromioplasty. The roentgenograms included anteroposterior, axillary, 30 degrees caudal tilt, and supraspinatus outlet views. The roentgenograms were measured by four independent readers. The separate views were then scored for reliability, and the correlation of the measurements with intraoperative acromial measurements was assessed. Interobserver reliability was highest for the caudal tilt view (0.84) and lowest for the axillary view (0.09). The supraspinatus and caudal tilt views correlated significantly with distinct intraoperative measurements of acromial spur size. We continue to advocate the evaluation of both views for preoperative assessment of the acromial spur in the rotator cuff impingement syndrome.

Acromion↗
PubMed1999

[The value of radiological examination in the diagnosis of rotator cuff tear].

The aim of this paper was to evaluate the correlation between radiological changes on a-p radiograph of the shoulder and rotator cuff tear on the ground of analysis of 328 patients (360 shoulders) aged between 11 and 73 years suffering from different forms of periarthritis humeroscapularis. Sonographic examination revealed rotator cuff tear in 54 shoulders; 38 confirmed at surgery and 16 at arthrography. There was very strong correlation between rotator cuff tear and irregularities of greater tubercle, narrowing of the distance between humeral head and acromion to 5 mm or less, greater tubercle recession, osteophytes and reverse shape of acromion. Last 3 changes were very strongly correlated with medium and large size rotator cuff tear.

Adolescent↗
PubMed2005

Limitations of isokinetic testing to determine shoulder strength after rotator cuff repair.

Some investigators have reported incomplete data when using isokinetic testing as a means of analyzing shoulder strength after rotator cuff repair. An explanation provided has been that the subjects could not reach the speed at which the machine was set. The purpose of this study was to determine if strength data could be generated for all motions being tested by using not only the one or two speeds employed by others, but three speeds across the spectrum of those available. Inclusion criteria were a minimum of two years since surgery with a normal contralateral shoulder. All eligible subjects had isokinetic testing of the non-operated shoulder followed by the operated shoulder, in flexion, abduction and external rotation, tested at 60 degrees, 120 degrees and 180 degrees per second. Fourteen patients were eligible and tested. Isokinetic data showed deficiencies in strength in the operated shoulder compared to the opposite side for abduction, external rotation and flexion of 14%, 27% and 20% respectively. In 10/123 (8%) of the tests, the patients could not reach the preset velocity to yield valid data. One patient could not place and maintain the operated arm in the test position of 90 degrees of shoulder abduction. There was a significant deficiency in abduction at only one of three speeds. This study confirms that isokinetic testing is a powerful tool that lends itself well to producing objective data on shoulder strength after rotator cuff repair, but it also has the limitation that some patients cannot reach the preset velocity for some motions, or place and maintain the operated arm in the test position for the movements being tested. Therefore, to optimize the chances of obtaining isokinetic data for all movements after rotator cuff repair, we suggest using speeds for all motions and consideration of scapular, frontal and sagittal planes for testing.

Adult↗
PubMed2001

Indirect MR arthrography of the shoulder in detection of rotator cuff ruptures.

The aim of this study was to compare the efficacy of indirect MR arthrography images obtained following intravenous contrast injection and conventional MR imaging in the diagnosis of rotator cuff tears. Twenty-four patients with clinically suspected rotator cuff disease were examined. Conventional MR images and post-contrast indirect MR arthrography images were obtained. All images were evaluated in a blinded fashion by two musculoskeletal radiologist. Results were than analyzed depending on surgical output. The correlation coefficient (Spearman rank correlation test) and the kappa values for agreement between surgery and imaging techniques were calculated. The correlation coefficients between indirect MR arthrography and surgery for reader 1 and reader 2 were 0.9137 and 0.9773, respectively. Whereas the agreement between conventional MR imaging and surgery was moderate (n = 0.383-0.571), the agreement between indirect MR arthrography and surgery was excellent (n = 0.873-0.936). We suggest the use of indirect MR arthrography technique when conventional MR images are equivocal in diagnosis of rotator cuff disease.

Adolescent↗
PubMed1986

[Rotator cuff ruptures of the shoulder joint. Sonography--arthrography].

47 patients suspected of rupture of the rotator cuff were sonographed and arthrographed. Rupture of the rotator cuff was diagnosed in 12 cases, both diagnostic methods yielding the same result. In 29 patients sonography and arthrography did not reveal any abnormal findings. Six ruptures evident in sonography were not confirmed by arthrography and were considered false positive. Direct pointers towards rupture of the cuff would be: echoless defects, cuff cannot be visualised fully or in part, irregularities of movement during dynamic examination. Echoless "cystic" areas in the periarticular soft parts must be considered an indirect pointer. Echorich focal findings in the echopoor cuff represent a differential diagnostic problem and we cannot give a final assessment as yet. Shoulder sonography is justified as a screening method in suspicion of rotator cuff rupture before initiating arthrography. If sonography reveals no abnormal findings, shoulder arthrography need not be performed.

Arthrography↗
PubMed1996

MR imaging of the rotator cuff mechanism: comparison of spin-echo and turbo spin-echo sequences.

OBJECTIVE: Although well documented in other MR imaging applications, the value of turbo spin-echo sequences in evaluating the shoulder has not been addressed. This study was designed to directly compare matched spin-echo and turbo spin-echo sequences in the MR imaging evaluation of the rotator cuff. MATERIALS AND METHODS: Using otherwise matched double-echo sequences of equal time duration, we performed 123 paired spin-echo (TR/TE, 200/25,75; one excitation) and turbo spin-echo (3500-5000/22,90; two excitations) sequences in the paracoronal and/or parasagittal plane of the shoulders of 76 patients referred to our institution for possible rotator cuff tear. The sequences were retrospectively analyzed for cuff signal and morphology, fluid conspicuity, coracoacromial arch morphology, and bone marrow signal abnormalities. Surgical and nonsurgical clinical results were correlated when available. RESULTS: We found 100% diagnostic correlation between spin-echo and turbo spin-echo sequences for rotator cuff integrity. Surgical data were available for 26 patients, and clinical follow-up for another 37. For complete rotator cuff tear in the surgical subpopulation, sensitivity was 89%, specificity was 94%, and diagnostic accuracy was 24 of 26 (92%). We found no diagnostically significant difference between the two imaging sequences for fluid conspicuity, coracoacromial morphology, or marrow signal. Signal-to-noise ratios were superior in the turbo spin-echo sequences. CONCLUSION: Turbo spin-echo sequences are an accurate and efficient tool in the MR imaging evaluation of the rotator cuff. Potential benefits include time saving, increased spatial resolution, and improved signal-to-noise ratio.

Adolescent↗
PubMed2007

Sonography of the rotator cuff in painful shoulders performed without knowledge of clinical information: results from 58 sonographic examinations with surgical correlation.

PURPOSE: To assess the value of sonography as an isolated diagnostic test for the detection and quantification of rotator cuff tears. METHODS: Preoperative sonographic examination was performed on 58 shoulders. Key biases on sonographic interpretation such as history-taking, physical examination, or concurrent imaging examinations were excluded by way of blinding. Tears of the rotator cuff were the positive findings of interest. Assessment of tear size and localization was done sonographically, and the results were compared with operative findings. RESULTS: All 24 full-thickness tears observed at surgery had been diagnosed correctly via sonography. In 19 of 20 cases with an intact rotator cuff, preoperative sonography was negative. Thirteen of 14 partial-thickness tears were not detected via sonography; 1 was misinterpreted as a full-thickness tear. Location of the tears relative to the rotator cuff tendons was described correctly in 21 of 25 cases. For tear size measurement, the 95% range of agreement was less than +/-1 cm. CONCLUSIONS: Blinded sonographic examination is effective in the detection and quantification of full-thickness tears of the rotator cuff but lacks sensitivity in the detection of partial-thickness tears.

Adolescent↗
PubMedDate not supplied

Ultrasound and MRI for the long-term evaluation of surgical repair of the rotator cuffs.

About 1 year after surgery to repair the rotator cuff, a total of 20 patients (80% monotendinous injuries, 20% bitendinous injuries) were submitted to ultrasound and MRI to evaluate repair, quality of residual tissue, and to reveal any discrepancies between the two instrumental tests. The results showed that there was normal tendinous integrity in 16 cases (group A), while there were partial injuries, without evidence of complete lesion, in 4 cases (group B); tendinous thinning was evident in 10 patients (50%), while there were areas of intratendinous degeneration in 40% of the cases. The authors observed agreement between the data obtained by the two methods in 75% of cases, and emphasize the effectiveness of the two methods in postoperative evaluation of the cuff; they also confirm the tendinous dishomogeneousness observed in the patients in group B, not associated with poor clinical results, considering the absence of significant differences in the functional results between the two groups.

Aged↗
PubMed2003

Magnetic resonance imaging of the rotator cuff muscles after baseball pitching.

AIM: The purposes of present study were to investigate quantitatively using functional MR imaging the effect of a series of throwing activities on rotator cuff muscles and to compare the effect of pitching with that of all-out shoulder external rotator exercise as the targeted external rotator muscle group (the infraspinatus and the teres minor). METHODS EXPERIMENTAL DESIGN: MRI measurements after 135 baseball pitches or all-out shoulder external rotator exercise (concentric mode) in each subject's nondominant shoulder. PARTICIPANTS: 6 amateur baseball pitchers. MEASURES: serial T2-weighted images of rotator cuff muscles were obtained before pitching (or shoulder exercise) and immediately, 30, 60 min, 24, 48, 96 hrs after pitching (or shoulder exercise). T2 relaxation times (T2) at each measurement time were calculated for the rotator cuff muscles. RESULTS: Both the supraspinatus and the external rotator muscle group showed significant T2 elevations until 96 hrs after pitching. The subscapularis also showed significantly increased T2 until postpitching 48 hrs. On the other hand, a significant T2 elevation continued until 60 min after shoulder exercise, but thereafter returned towards the value at rest over the next 24 hrs. CONCLUSION: Long lasting T2 elevations in rotator cuff muscles would be associated with an increase in each intramuscular water content, and may be attributed to the muscle damage that resulted from eccentric contraction during pitching. This information should serve as a useful complement to shoulder injury prevention for baseball pitchers.

Adult↗