HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Herold, T. Articles by Paetzel, C. Search for Related Content PubMed PubMed Citation Articles by Herold, T. Articles by Paetzel, C.

Indirect MR Arthrography of the Shoulder: Use of Abduction and External Rotation to Detect Full- and Partial-Thickness Tears of the Supraspinatus Tendon¹

¹ From the Department of Diagnostic Radiology, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, D-93042 Regensburg, Germany. Received March 18, 2005; revision requested May 12; revision received May 27; accepted June 21; final version accepted August 11. Address correspondence to T.H. (e-mail: thomas.herold{at}klinik.uni-regensburg.de).

View larger version (144K): [in a new window]   Figure 1a: Full-thickness tear of the supraspinatus tendon in 47-year-old man. (a) Coronal oblique fat-saturated T1-weighted contrast material–enhanced indirect MR arthrogram (1011/20) obtained with patient in the neutral position shows incomplete element interruption (long arrow) in bursal-side fibers of supraspinatus tendon. On the joint-side surface, tendon seems to be intact (short arrows). Both readers assessed this lesion as a bursal-side partial-thickness tear. (b) Corresponding image obtained with patient in the ABER position (1011/20) demonstrates complete discontinuity of the tendon, which was filled by enhanced granulated tissue (arrows). Full-thickness tear was confirmed at arthroscopy.

View larger version (159K): [in a new window]   Figure 1b: Full-thickness tear of the supraspinatus tendon in 47-year-old man. (a) Coronal oblique fat-saturated T1-weighted contrast material–enhanced indirect MR arthrogram (1011/20) obtained with patient in the neutral position shows incomplete element interruption (long arrow) in bursal-side fibers of supraspinatus tendon. On the joint-side surface, tendon seems to be intact (short arrows). Both readers assessed this lesion as a bursal-side partial-thickness tear. (b) Corresponding image obtained with patient in the ABER position (1011/20) demonstrates complete discontinuity of the tendon, which was filled by enhanced granulated tissue (arrows). Full-thickness tear was confirmed at arthroscopy.

View larger version (152K): [in a new window]   Figure 2a: Joint-side partial-thickness tear of the supraspinatus tendon in 37-year-old man. (a) Coronal oblique fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the neutral position demonstrates element interruption (arrow) of articular-side fiber of tendon. (b) Fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the ABER position shows partial-thickness tear (arrow).

View larger version (158K): [in a new window]   Figure 2b: Joint-side partial-thickness tear of the supraspinatus tendon in 37-year-old man. (a) Coronal oblique fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the neutral position demonstrates element interruption (arrow) of articular-side fiber of tendon. (b) Fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the ABER position shows partial-thickness tear (arrow).

View larger version (180K): [in a new window]   Figure 3a: Bursal-side partial-thickness tear of the supraspinatus tendon in 43-year-old woman. (a) Coronal oblique fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the neutral position does not depict tear because neither suspected morphologic changes nor signal intensity alterations are visible (arrow). (b) Fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the ABER position shows how tendon kinking causes the spreading of fibers and correctly demonstrates bursal-side partial-thickness tear (long arrow) with horizontal component (short arrow).

View larger version (144K): [in a new window]   Figure 3b: Bursal-side partial-thickness tear of the supraspinatus tendon in 43-year-old woman. (a) Coronal oblique fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the neutral position does not depict tear because neither suspected morphologic changes nor signal intensity alterations are visible (arrow). (b) Fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the ABER position shows how tendon kinking causes the spreading of fibers and correctly demonstrates bursal-side partial-thickness tear (long arrow) with horizontal component (short arrow).

View larger version (170K): [in a new window]   Figure 4a: Joint-side partial-thickness tear of the supraspinatus tendon in 55-year-old woman. (a) Coronal oblique contrast-enhanced fat-saturated T1-weighted indirect MR arthrogram (1011/20) obtained with patient in the neutral position shows low-signal-intensity supraspinatus tendon (arrow), with no alteration in signal intensity. Both readers classified this as no tear. (b) Corresponding image (1011/20) obtained with patient in the ABER position depicts small flap (arrow) on joint-side area of tendon. Joint-side partial-thickness tear was correctly diagnosed by both readers.

View larger version (174K): [in a new window]   Figure 4b: Joint-side partial-thickness tear of the supraspinatus tendon in 55-year-old woman. (a) Coronal oblique contrast-enhanced fat-saturated T1-weighted indirect MR arthrogram (1011/20) obtained with patient in the neutral position shows low-signal-intensity supraspinatus tendon (arrow), with no alteration in signal intensity. Both readers classified this as no tear. (b) Corresponding image (1011/20) obtained with patient in the ABER position depicts small flap (arrow) on joint-side area of tendon. Joint-side partial-thickness tear was correctly diagnosed by both readers.

View larger version (159K): [in a new window]   Figure 5a: Intratendinous partial-thickness tear of the supraspinatus tendon in 45-year-old man. (a) Coronal oblique fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the neutral position shows supraspinatus tendon (arrow) with normal signal intensity and without morphologic changes. (b) Fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the ABER position demonstrates no surface abnormalities but depicts linear area of high signal intensity (arrow) within tendon and small space between fibers. Both readers correctly interpreted these signal intensity and morphologic alterations as indicative of an intratendinous partial-thickness tear.

View larger version (188K): [in a new window]   Figure 5b: Intratendinous partial-thickness tear of the supraspinatus tendon in 45-year-old man. (a) Coronal oblique fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the neutral position shows supraspinatus tendon (arrow) with normal signal intensity and without morphologic changes. (b) Fat-saturated T1-weighted contrast-enhanced indirect MR arthrogram (1011/20) obtained with patient in the ABER position demonstrates no surface abnormalities but depicts linear area of high signal intensity (arrow) within tendon and small space between fibers. Both readers correctly interpreted these signal intensity and morphologic alterations as indicative of an intratendinous partial-thickness tear.