A comparative analysis of fatty infiltration and muscle atrophy in patients with chronic rotator cuff tears and suprascapular neuropathy

医学 肩胛上神经 肩袖 肩膀 萎缩 冈上肌 眼泪 肩袖损伤 磁共振成像 肌肉萎缩 肱二头肌 肌萎缩 袖口 解剖 外科 内科学 放射科 臂丛神经
作者
Silvan Beeler,Eugene T. Ek,Christian Gerber
出处
期刊:Journal of Shoulder and Elbow Surgery [Elsevier]
卷期号:22 (11): 1537-1546 被引量:88
标识
DOI:10.1016/j.jse.2013.01.028
摘要

Little is known of the mechanisms that lead to the muscle changes associated with rotator cuff disorders. We have observed that the magnetic resonance imaging (MRI) appearance of fatty infiltration (FI) and muscle atrophy (MA) differ between chronic cuff tears and suprascapular neuropathy, suggesting different pathophysiology. This study compares the different MRI changes that occur in chronic cuff tears and suprascapular neuropathy.Two groups were retrospectively identified: (1) RCT group (20 shoulders): patients with chronic tears of the supraspinatus and/or infraspinatus without electromyographic (EMG) evidence of suprascapular neuropathy; (2) neuro group (17 shoulders): patients with EMG documented suprascapular nerve dysfunction and absence of a rotator cuff tear. Magnetic resonance arthrograms were analyzed for the degree of FI and MA, and the morphology of the muscle was assessed, in particular the muscle border, pattern of FI, and extent of involvement.The muscle changes that occur following chronic cuff tears differ from that following denervation secondary to suprascapular neuropathy, especially with respect to the muscle border, degree of perineural fat, and overall distribution of FI. Highly specific and characteristic morphological patterns of FI exist for both chronic cuff tears and suprascapular neuropathy.Chronic rotator cuff tendon tears and suprascapular neuropathy are both associated with FI and MA of the rotator cuff muscles. The pattern of FI is markedly different in the 2 situations. These findings have diagnostic potential and may serve as a basis for further research concerning type, severity, and evolution of FI under different conditions and after treatment.
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