Skip to main content
Log in

Could radio-morphological changes in humerus greater tuberosity be an early indicator of rotator cuff tendon injuries?

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Objectives

To reveal the possible relationship between greater tuberosity volume with rotator cuff tendon injuries.

Materials and methods

In our study, the morphology of the greater tuberosity was evaluated retrospectively by using radiographs and MR images of 335 cases. While critical shoulder angle (CSA) was measured on radiographs, greater tuberosity (GT) area and volume were calculated, and also supraspinatus, infraspinatus, and teres minor tendons were evaluated, on MR images. The relationship of the measurements with the tendon injuries was analyzed statistically.

Results

Among 188 female and 147 male patients, no statistically significant relationship was found between tendon injuries in terms of gender. The relationships between supra and infraspinatus tendon injuries and GT angle, area, and volume measurements were statistically significant. There was a statistically significant relationship between teres minor injury and GT angle, but no significant correlation with GT area and volume. Finally, there was no statistically significant correlation between all three tendon pathologies and CSA.

Conclusion

Area, and especially volume measurements, which are morphological features of the GT, may reflect tendon damage without significant degenerative changes in the bone structure. In examinations before tendon damage progresses, GT volume is a morphological feature that needs to be evaluated and may facilitate early recognition of tendinopathies and be an early marker of rotator cuff injuries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Murphy RJ, Carr AJ. Shoulder pain. BMJ Clin Evid. 2010:1107. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217726/citedby/

  2. Tashjian RZ. Epidemiology, natural history, and indications for treatment of rotator cuff tears. Clin Sports Med. 2012;31(4):589–604.

    Article  Google Scholar 

  3. Cunnigham G, Nicodeme-Paulin E, Smith MM, Holzer N, Cass B, Young AA. The greater tuberosity angle: a new predictor for rotator cuff tear. J Shoulder Elbow Sur. 2018;27:1415–21.

    Article  Google Scholar 

  4. Loriaud A, Bise S, Meyer P, et al. Critical shoulder angle: what do radiologists need to know? Skelet Radiol. 2020;49:515–20.

    Article  Google Scholar 

  5. Okoroha KR, Mehran N, Duncan J, et al. Characterization of rotator cuff tears: ultrasound versus magnetic resonance imaging. Orthopedics. 2017;40:124–30.

    Google Scholar 

  6. Strobel K, Hodler J, Meyer DC, Pfirrmann CW, Pirkl C, Zanetti M. Fatty atrophy of supraspinatus and infraspinatus muscles: accuracy of US. Radiology. 2005;237:584–9.

    Article  Google Scholar 

  7. Hamrick MW, McGee-Lawrence ME, Frechette DM. Fatty infiltration of skeletal muscle: mechanisms and comparisons with bone marrow adiposity. Front Endocrinol (Lausanne). 2016;7:69.

    Article  Google Scholar 

  8. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg. 1999;8:599–605.

    Article  CAS  Google Scholar 

  9. Gladstone JN, Bishop JY, Lo IK, Flatow EL. Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome. Am J Sports Med. 2007;35:719–28.

    Article  Google Scholar 

  10. Godenèche A, Elia F, Kempf JF, et al. Fatty infiltration of stage 1 or higher significantly compromises longterm healing of supraspinatus repairs. J Shoulder Elbow Surg. 2017;26:1818–25.

    Article  Google Scholar 

  11. Goutallier D, Bernageau J, Patte D. Assessment of the trophicity of the muscles of the ruptured rotator cuff by CT scan. In: Post M, Morrey B, Hawkins R, editors. Surgery of the shoulder. St. Louis, MO: Mosby; 1990. p. 11–3.

    Google Scholar 

  12. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994;304:78–83.

    Article  Google Scholar 

  13. Moor BK, Kuster R, Osterhoff G, et al. Inclination-dependent changes of the critical shoulder angle significantly influence superior glenohumeral joint stability. Clin Biomech Bristol Avon. 2016;32:268–73.

    Article  CAS  Google Scholar 

  14. Yasar F, Imamoglu T, Adam G, Erdogan N. Comparıson of Cavalieri method with the formula in calculation of liver volume in magnetic resonance imaging. Tepecik Eğit Hast Derg. 2011;21(1):19–24.

    Article  Google Scholar 

  15. Nyffeler RW, Meyer DC. Acromion and glenoid shape: why are they important predictive factors for the future of our shoulders? EFORT Open Rev. 2017;2(5):141–50.

    Article  Google Scholar 

  16. Nyffeler RW, Werner CML, Sukthankar A, Schmid MR, Gerber C. Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg Am. 2006;88(4):800–5.

    PubMed  Google Scholar 

  17. Pesquer L, Borghol S, Meyer P, Ropars M, Dallaudière B, Abadie P. Multimodality imaging of subacromial impingement syndrome. Skelet Radiol. 2018;47(7):923–37.

    Article  Google Scholar 

  18. Hughes RE, Bryant CR, Hall JM, et al. Glenoid inclination is associated with full-thickness rotator cuff tears. Clin Orthop. 2003;407:86–91.

    Article  Google Scholar 

  19. Tétreault P, Krueger A, Zurakowski D, Gerber C. Glenoid version and rotator cuff tears. J Orthop Res Off Publ Orthop Res Soc. 2004;22(1):202–7.

    Article  Google Scholar 

  20. Moor BK, Bouaicha S, Rothenfluh DA, Sukthankar A, Gerber C. Is there an association between the individual anatomy of the scapula and the development of rotator cuff tears or osteoarthritis of the glenohumeral joint? A radiological study of the critical shoulder angle. Bone Jt J. 2013;95-B(7):935–41.

    Article  CAS  Google Scholar 

  21. Moor BK, Wieser K, Slankamenac K, Gerber C, Bouaicha S. Relationship of individual scapular anatomy and degenerative rotator cuff tears. J Shoulder Elb Surg. 2014;23(4):536–41.

    Article  Google Scholar 

  22. Blonna D, Giani A, Bellato E, et al. Predominance of the critical shoulder angle in the pathogenesis of degenerative diseases of the shoulder. J Shoulder Elb Surg. 2016;25(8):1328–36.

    Article  Google Scholar 

  23. Cherchi L, Ciornohac JF, Godet J, Clavert P, Kempf J-F. Critical shoulder angle: measurement reproducibility and correlation with rotator cuff tendon tears. Orthop Traumatol Surg Res. 2016;102(5):559–62.

    Article  CAS  Google Scholar 

  24. Suter T, Popp AG, Zhang Y, Zhang C, Tashjian RZ, Henninger HB. The influence of radiographic viewing perspective and demographics on the critical shoulder angle. J Shoulder Elb Surg. 2015;24(6):e149–58.

    Article  Google Scholar 

  25. Chuang HC, Hong CK, Hsu KL, Kuan FC, Lin CL, Su WR. The radiographic morphology of the greater tuberosity is associated with muscle degeneration in patients with symptomatic rotator cuff tears. J. Shoulder Elbow Surg. 2019; 1–7.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nilüfer Aylanç.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aylanç, N., Ertem, Ş.B. Could radio-morphological changes in humerus greater tuberosity be an early indicator of rotator cuff tendon injuries?. Skeletal Radiol 51, 649–657 (2022). https://doi.org/10.1007/s00256-021-03864-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-021-03864-y

Keywords

Navigation