The pattern of idiopathic isolated teres minor atrophy with regard to its two-bundle anatomy

  • Yusuhn Kang
  • Joong Mo Ahn
  • Choong Guen Chee
  • Eugene Lee
  • Joon Woo Lee
  • Heung Sik KangEmail author
Scientific Article



We aimed to analyze the pattern of teres minor atrophy with regard to its two-bundle anatomy and to assess its association with clinical factors.

Materials and methods

Shoulder MRIs performed between January and December 2016 were retrospectively reviewed. Images were evaluated for the presence and pattern of isolated teres minor atrophy. Isolated teres minor atrophy was categorized into complete or partial pattern, and partial pattern was further classified according to the portion of the muscle that was predominantly affected. The medical records were reviewed to identify clinical factors associated with teres minor atrophy.


Seventy-eight shoulders out of 1,264 (6.2%) showed isolated teres minor atrophy; complete pattern in 41.0%, and partial pattern in 59.0%. Most cases of partial pattern had predominant involvement of the medial–dorsal component (82.6%). There was no significant association between teres minor atrophy and previous trauma, shoulder instability, osteoarthritis, and previous operation. The history of shoulder instability was more frequently found in patients with isolated teres minor atrophy (6.4%), compared with the control group (2.6%), although the difference was not statistically significant.


Isolated teres minor atrophy may be either complete or partial, and the partial pattern may involve either the medial–dorsal or the lateral–ventral component of the muscle. The imaging findings of partial pattern teres minor atrophy indicate that the two muscle components may have separate innervation.


Magnetic resonance imaging Shoulder Rotator cuff Teres minor Isolated teres minor atrophy 


Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was waived.


  1. 1.
    Sofka CM, Lin J, Feinberg J, Potter HG. Teres minor denervation on routine magnetic resonance imaging of the shoulder. Skeletal Radiol. 2004;33(9):514–8.CrossRefPubMedGoogle Scholar
  2. 2.
    Crouch DL, Plate JF, Li Z, Saul KR. Biomechanical contributions of posterior deltoid and teres minor in the context of axillary nerve injury: a computational study. J Hand Surg Am. 2013;38(2):241–9.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Otis JC, Jiang CC, Wickiewicz TL, Peterson MG, Warren RF, Santner TJ. Changes in the moment arms of the rotator cuff and deltoid muscles with abduction and rotation. J Bone Joint Surg Am. 1994;76(5):667–76.CrossRefPubMedGoogle Scholar
  4. 4.
    Kikukawa K, Ide J, Kikuchi K, Morita M, Mizuta H, Ogata H. Hypertrophic changes of the teres minor muscle in rotator cuff tears: quantitative evaluation by magnetic resonance imaging. J Shoulder Elbow Surg. 2014;23(12):1800–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Kikukawa K, Ide J, Terakawa Y, Takada K, Morita M, Hashimoto K, et al. Hypertrophic teres minor restores shoulder strength and range of external rotation in posterosuperior rotator cuff tears. J Shoulder Elbow Surg. 2016;25(11):1882–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Wilson L, Sundaram M, Piraino DW, Ilaslan H, Recht MP. Isolated teres minor atrophy: manifestation of quadrilateral space syndrome or traction injury to the axillary nerve? Orthopedics. 2006;29(5):447–50.PubMedGoogle Scholar
  7. 7.
    Friend J, Francis S, McCulloch J, Ecker J, Breidahl W, McMenamin P. Teres minor innervation in the context of isolated muscle atrophy. Surg Radiol Anat. 2010;32(3):243–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Jenp YN, Malanga GA, Growney ES, An KN. Activation of the rotator cuff in generating isometric shoulder rotation torque. Am J Sports Med. 1996;24(4):477–85.CrossRefPubMedGoogle Scholar
  9. 9.
    Gartsman GM. Massive, irreparable tears of the rotator cuff. Results of operative debridement and subacromial decompression. J Bone Joint Surg Am. 1997;79(5):715–21.CrossRefPubMedGoogle Scholar
  10. 10.
    Simovitch RW, Helmy N, Zumstein MA, Gerber C. Impact of fatty infiltration of the teres minor muscle on the outcome of reverse total shoulder arthroplasty. J Bone Joint Surg Am. 2007;89(5):934–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Berton A, Gulotta LV, Petrillo S, Florio P, Longo UG, Denaro V, et al. The effect of humeral version on teres minor muscle moment arm, length, and impingement in reverse shoulder arthroplasty during activities of daily living. J Shoulder Elbow Surg. 2015;24(4):578–86.CrossRefPubMedGoogle Scholar
  12. 12.
    Nove-Josserand L, Costa P, Liotard JP, Safar JF, Walch G, Zilber S. Results of latissimus dorsi tendon transfer for irreparable cuff tears. Orthop Traumatol Surg Res. 2009;95(2):108–13.CrossRefPubMedGoogle Scholar
  13. 13.
    Kim JK, Yoo HJ, Jeong JH, Kim SH. Effect of teres minor fatty infiltration on rotator cuff repair outcomes. Arthroscopy. 2016;32(4):552–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Collin P, Treseder T, Denard PJ, Neyton L, Walch G, Ladermann A. What is the best clinical test for assessment of the teres minor in massive rotator cuff tears? Clin Orthop Relat Res. 2015;473(9):2959–66.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Millett PJ, Schoenahl JY, Allen MJ, Motta T, Gaskill TR. An association between the inferior humeral head osteophyte and teres minor fatty infiltration: evidence for axillary nerve entrapment in glenohumeral osteoarthritis. J Shoulder Elbow Surg. 2013;22(2):215–21.CrossRefPubMedGoogle Scholar
  16. 16.
    Melis B, DeFranco MJ, Ladermann A, Barthelemy R, Walch G. The teres minor muscle in rotator cuff tendon tears. Skeletal Radiol. 2011;40(10):1335–44.CrossRefPubMedGoogle Scholar
  17. 17.
    Costouros JG, Espinosa N, Schmid MR, Gerber C. Teres minor integrity predicts outcome of latissimus dorsi tendon transfer for irreparable rotator cuff tears. J Shoulder Elbow Surg. 2007;16(6):727–34.CrossRefPubMedGoogle Scholar
  18. 18.
    Kruse LM, Yamaguchi K, Keener JD, Chamberlain AM. Clinical outcomes after decompression of the nerve to the teres minor in patients with idiopathic isolated teres minor fatty atrophy. J Shoulder Elbow Surg. 2015;24(4):628–33.CrossRefPubMedGoogle Scholar
  19. 19.
    Kallio MA, Kovala TT, Niemela EN, Huuskonen UE, Tolonen EU. Shoulder pain and an isolated teres minor nerve lesion. J Clin Neurophysiol. 2011;28(5):524–7.PubMedGoogle Scholar
  20. 20.
    Brestas PS, Tsouroulas M, Nikolakopoulou Z, Malagari K, Drossos C. Ultrasound findings of teres minor denervation in suspected quadrilateral space syndrome. J Clin Ultrasound. 2006;34(7):343–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Linker CS, Helms CA, Fritz RC. Quadrilateral space syndrome: findings at MR imaging. Radiology. 1993;188(3):675–6.CrossRefPubMedGoogle Scholar
  22. 22.
    Cothran RL Jr, Helms C. Quadrilateral space syndrome: incidence of imaging findings in a population referred for MRI of the shoulder. AJR Am J Roentgenol. 2005;184(3):989–92.CrossRefPubMedGoogle Scholar
  23. 23.
    Hamada J, Nimura A, Yoshizaki K, Akita K. Anatomic study and electromyographic analysis of the teres minor muscle. J Shoulder Elbow Surg. 2017;26(5):870–7.CrossRefPubMedGoogle Scholar
  24. 24.
    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.Google Scholar
  25. 25.
    Chafik D, Galatz LM, Keener JD, Kim HM, Yamaguchi K. Teres minor muscle and related anatomy. J Shoulder Elbow Surg. 2013;22(1):108–14.CrossRefPubMedGoogle Scholar
  26. 26.
    Bryan WJ, Schauder K, Tullos HS. The axillary nerve and its relationship to common sports medicine shoulder procedures. Am J Sports Med. 1986;14(2):113–6.CrossRefPubMedGoogle Scholar
  27. 27.
    Perlmutter GS. Axillary nerve injury. Clin Orthop Relat Res. 1999(368):28–36.Google Scholar
  28. 28.
    Loehr JF, Helmig P, Sojbjerg JO, Jung A. Shoulder instability caused by rotator cuff lesions. An in vitro study. Clin Orthop Relat Res. 1994(304):84–90.Google Scholar
  29. 29.
    Brown SA, Doolittle DA, Bohanon CJ, Jayaraj A, Naidu SG, Huettl EA, et al. Quadrilateral space syndrome: the Mayo Clinic experience with a new classification system and case series. Mayo Clin Proc. 2015;90(3):382–94.CrossRefPubMedGoogle Scholar

Copyright information

© ISS 2018

Authors and Affiliations

  • Yusuhn Kang
    • 1
  • Joong Mo Ahn
    • 1
  • Choong Guen Chee
    • 1
  • Eugene Lee
    • 1
  • Joon Woo Lee
    • 1
  • Heung Sik Kang
    • 1
    Email author
  1. 1.Department of RadiologySeoul National University Bundang HospitalSeongnam-siKorea

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