Rotator Cuff Imaging Techniques.
Last updated Wednesday, January 26, 2005
Radiographs
Standard radiographs can provide limited assistance in evaluating shoulder weakness.Plain radiographs Small avulsed fragments of the tuberosity may be seen in younger
patients with cuff lesions (see figure 1) (not to be confused with
calcific deposits). Chronic cuff disease may be accompanied by
sclerosis of the undersurface of the acromion (the "sourcil" or eyebrow
sign) (see figure 2), traction spurs in the coracoacromial ligament
from forced contact with the cuff and the humeral head and changes at
the cuff insertion to the humerus (see figures 3-5). (Diamond, 1964,
Inman, Saunders, 1944, Johansson and Barrington, 1984, Meyer, 1931,
Weiner and Macnab, 1970b) Radiographs may also reveal evidence of some
of the conditions possibly associated with cuff disease, such as
acromioclavicular arthritis, chronic calcific tendinitis, tuberosity
displacement, and the like (see figures 6-8). With larger tears
radiographs reveal upward displacement of the head of the humerus with
respect to the glenoid and acromion (see figures 9-12). (Colachis and
Strohm, 1971, Diamond, 1964, Ismail, Balakishnan, 1969, Julliard, 1933,
Lilleby, 1984, Weiner and Macnab, 1970b) Kaneko et al (Kaneko, DeMouy,
1995) found that superior migration of the humerus and deformity of the
greater tuberosity were the most sensitive and specific manifestations
of massive cuff deficiency. In cuff tear arthropathy, the humeral head
may have lost the prominence of the tuberosities (become "femoralized")
and the coracoid, acromion, and glenoid may have formed a deep
spherical socket (become "acetabularized") (see figures 5 and 13-15).
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