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By David W Stoller; et al

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J Am Acad Orthop Surg 6(4):259-66, 1998 Cohen RB et al: Impingement syndrome and rotator cuff disease as repetitive motion disorders. Clin Orthop (351):95-101,1998 Fritz RC et al: MR imaging of the rotator cuff. Magn Reson Imaging Clin N Am 5(4):735-54,1997 Neer CD et al: Cuff-tear arthropathy. J Bone Joint Surg 65(9):1232-44, 1983 ROTATOR CUFF TENDINOPATHY Typical (LLfl) Coronal PD FSE MR shows increased signal intensity within the supraspinatus critical zone (arrow), consistent with tendinopathy.

I Typical (I&) Coronal graphic shows a tear of the infraspinatus component of the rotator cuff. This is often seen in posterosuperior (internal) glenoid impingement (PSCI). (Right) Coronal FS PD FSE MR shows a tear of the infraspinatus tendon (arrow). (Left) Sagittal FS PD FSE MR shows tearing of the posterior supraspinatus and infraspinatus (arrow) in a patient with posterosuperior (internal) glenoid impingement (PSCI). (Right) Axial FS PD FSE MR shows a full thickness tear (arrow) of the supraspinatus tendon.

Right) Sagittal FS PD FSE MR shows tendinopathy (arrow) predominantly affecting the posterior cuff tendon. 1 ROTATOR CUFF PARTIAL THICKNESS TEAR Coronal graphic shows a partial undersurface tear of the supraspinatus tendon involving the critical zone. Coronal FS PD FSE M R shows an articular surface partial tear (arrow) of the supraspinatus involving the critical zone. o Abbreviations and Synonyms +/- Anatomically sealed (closed) in the adducted shoulder imaging position Radiographic Findings Partial rotator cuff tear (PRTC Tear) Radiography o Findings associated with impingement Acromial spurs Type I11 (hooked) acromion Humeral head (HH) arthritic changes of greater tuberosity Acromioclavicular (AC) degenerative changes Definitions Incomplete (partial) tear of tendon of rotator cuff o Supraspinatus tendon most common o Three types Bursa1 surface Interstitial (within substance noncommunicating) Articular surface MR Findings General Features Best diagnostic clue o Incomplete tear or gap in the RTC tendon filled with joint bursal fluid, +/- granulation tissue o FS PD FSE or T2WI Location: Supraspinatus (SST) bursal or articular surfaces or within tendon Size: Varies from fraying to large dissecting partial tear Morphology o Irregularity (fraying) to flap morphology TlWI o Thickening of RTC tendons, of intermediate signal intensity o Calcifications in the supraspinatus, infraspinatus or teres minor = calcific tendinitis o Hypointense bone impaction (Hill-Sachs) - anterior dislocation Rotator cuff strain associated o Marrow containing acromial spur (marrow fat) T2WI o Fluid signal intensity filling an incomplete gap in the tendon FS PD FSE Gap - articular surface or bursal surface Interstitial, noncommunicating gap o +/- Fluid within the subacromial bursa EH DDx: Rotator Cuff Partial Thickness Tear Ca++ Tendinitis Cor FS PD FSE Cor Tl Arthro.

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