Prevalence and Grading of Rotator Cuff and Labral Injuries in Shoulder Pain and Instability using MRI: A Cross-sectional Study
Introduction: Shoulder joint is a highly mobile joint but is prone for rotator cuff injuries and dislocations. It is necessary to accurately diagnose rotator cuff and labral injuries so that appropriate plan of action for treatment can be taken. Magnetic Resonance Imaging (MRI) can be used to di...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-05-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/14845/48773_CE[Ra]_F(Sh)_PF1(AG_SL)_PFA(Pr_KM)_PN(KM).pdf |
| Summary: | Introduction: Shoulder joint is a highly mobile joint but is
prone for rotator cuff injuries and dislocations. It is necessary
to accurately diagnose rotator cuff and labral injuries so that
appropriate plan of action for treatment can be taken. Magnetic
Resonance Imaging (MRI) can be used to diagnose and describe
the extent of rotator cuff tendon and labral injuries and any
secondary rotator cuff muscle abnormalities.
Aim: To study the demographic profile of patients presenting
with shoulder pain and instability, identify the various rotator cuff
injuries causing shoulder pain, identify the rotator cuff interval
lesions causing microinstability, identify the various labral and
bony pathologies in instability, describe the MRI features of the
rotator cuff, rotator cuff interval, labral and bony injuries.
Materials and Methods: This study was a cross-sectional
study of patients with symptoms of either shoulder pain or
instability who underwent MRI evaluation of the shoulder in the
Department of Radiodiagnosis, Rajarajeswari Medical College
and Hospital, Bengaluru, Karnataka, India, from July 2018 to
December 2020. The study population consisted of 54 patients
with either shoulder pain or instability who underwent MRI of
shoulder. All the MRI scans of the shoulder in this study were
performed using 1.5 Tesla Siemens Magnetom Avanto (Tim
76x18) MR machine using a flex coil.
Results: The study population consisted of 54 patients
comprising of 38 males and 16 females. The age of the patients
ranged from 20-77 years. Majority of the patients were older
than 50 years constituting about 33.33% of the total study
population. Rotator cuff injury was the commonest cause of
pain. Tendinosis was the commonest type of rotator cuff injury
followed by partial-thickness and full-thickness tendon tears.
The commonest grade of tendinosis was mild or grade 1.
Supraspinatus tendon was the most commonly affected tendon
followed by subscapularis and infraspinatus tendons. Teres
minor tendon was normal in all the cases. Anterior instability
was the commonest type of instability with equal prevalence of
soft tissue Bankart, bony Bankart and Perthes lesions. Biceps
pulley lesions resulted in long head of biceps tendon instability,
microinstability and internal impingement.
Conclusion: Rotator cuff injuries are the commonest cause
of shoulder pain and are seen more frequently after the fifth
decade. Shoulder instability is most commonly seen in young
male adults. Tendinosis is the commonest type of rotator cuff
injury. Supraspinatus tendon is the most commonly injured
tendon. Anterior instability is the commonest type of shoulder
instability. Biceps pulley lesions result in long head of biceps
tendon instability, microinstability and internal impingement.
MRI can diagnose interstitial or intrasubstance tendon tears
which are not visualised on arthroscopy. MRI description of
tendon and labral tears, tendon retraction and muscle atrophy
can guide the orthopaedician during arthroscopy and in
treatment planning. |
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| ISSN: | 2249-782X 0973-709X |