Skip to main content

Advertisement

SpringerLink
Log in

Deltoid muscle and tendon tears in patients with chronic rotator cuff tears

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

Abstract

Purpose

To describe the magnetic resonance imaging (MRI) appearances of tears of the deltoid muscle and tendon in patients with rotator cuff tears and without a prior history of shoulder surgery.

Materials and methods

Deltoid tears diagnosed on MR examinations were prospectively recorded between February 2003 through June 2004. The images of these patients were then retrospectively reviewed to determine the location of the deltoid tear, the presence of rotator cuff tears, tendon retraction, muscle atrophy, degree of humeral head subluxation, bony erosive changes involving the undersurface of the acromion, and the presence of edema or fluid-like signal intensity in the deltoid muscle and overlying subcutaneous tissues.

Results

There were 24 (0.3%) patients with deltoid tears; nine men and 15 women. The age range was 54 to 87 (average 73) years. The right side was involved in 20 cases, and the left in four cases. Fifteen patients had full thickness and nine had partial thickness tears of the deltoid. Shoulder pain was the most common presenting symptom. The physical examination revealed a defect in the region of the deltoid in two patients. Nineteen patients had tears in the muscle belly near the musculotendinous junction, and five had avulsion of the tendon from the acromial origin. Full thickness rotator cuff tears were present in all of the patients, and 22 patients had associated muscle atrophy. Subcutaneous edema and fluid-like signal was present in 15 patients.

Conclusion

Tears of the deltoid muscle or tendon is an unusual finding, but they can be seen in patients with chronic massive rotator cuff tears. Partial thickness tears tend to involve the undersurface of the deltoid muscle and tendon. Associated findings such as intramuscular cyst or ganglion in the deltoid muscle belly and subcutaneous edema or fluid-like signal overlying the deltoid in a patient with a rotator cuff tear should raise the suspicion of a deltoid tear.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

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

Similar content being viewed by others

References

  1. Matsen FA III, Arntz CT. Rotator cuff tendon failure. In: Rockwood CA Jr, Matsen FA III, eds. The shoulder. Philadelphia: Saunders; 1990: 647–677.

    Google Scholar 

  2. Morisawa K, Yamashita K, Asami A, Nishikawa H, Watanabe H. Spontaneous rupture of the deltoid muscle associated with massive tearing of the rotator cuff. J Shoulder Elbow Surg 1997;6: 556–558.

    Article  CAS  Google Scholar 

  3. Panting AL, Hunter MH. Spontaneous rupture of the deltoid. J Bone Joint Surg 1983;65B: 518.

    Google Scholar 

  4. Yamaguchi K, Ito N, Eto M, Iwasaki K. Rupture of the deltoid muscle belly with tear of the rotator cuff: a case report. Seikei Geka 1993;44: 1663–1666.

    Google Scholar 

  5. Pointud P, Clerc D, Manigand G, Deparis M. Spontaneous rupture of the deltoid muscle. Nouv Presse Med 1976;5 (35): 2315–2316.

    CAS  Google Scholar 

  6. Allen AA, Drakos MC. Partial detachment of the deltoid muscle. A case report. Am J Sports Med 2002;30 (1):133–134.

    Article  Google Scholar 

  7. Samuel J, Levernieux J, de Seze S. A case of rupture of the deltoid muscle. Rev Rhum Mal Osteoartic 1975;42 (12): 769–771.

    CAS  Google Scholar 

  8. Bianchi S, Poletti PA, Martinoli C, Abdelwahab IF. Imaging findings of spontaneous detachment of the deltoid muscle as a complication of massive rotator cuff tear. Skeletal Radiol 2006;35 (6): 410–415.

    Article  Google Scholar 

  9. Blazar PE, Williams GR, Iannotti JP. Spontaneous detachment of the deltoid muscle origin. J Shoulder Elbow Surg 1998;7: 389–392.

    Article  CAS  Google Scholar 

  10. Stoller DW, eds. Magnetic resonance imaging in orthopedics and sports medicine. 2nd ed. Philadelphia-New York: Lippincot-Raven; 1997; 597–742.

    Google Scholar 

  11. Sanders TG, Tirman PF, Feller JF, Genant HK. Association of intramuscular cysts of the rotator cuff with tears of the rotator cuff: magnetic resonance imaging findings and clinical significance. Arthroscopy 2000;16 (3): 230–235.

    Article  CAS  Google Scholar 

  12. Rockwood CA Jr, Williams GR Jr, Burkhead WZ Jr. Debridement of degenerative, irreparable lesions of the rotator cuff. J Bone Joint Surg Am 1995;77: 857–866.

    Article  Google Scholar 

  13. Burkhart SS. Arthroscopic treatment of massive rotator cuff tears. Clinical results and biomechanical rationale. Clin Orthop Relat Res 1991;267: 45–56.

    Google Scholar 

  14. Franklin JL, Barrett WP, Jackins SE, Matsen FA 3rd. Glenoid loosening in total shoulder arthroplasty. Association with rotator cuff deficiency. J Arthroplasty 1988;3: 39–46.

    Article  CAS  Google Scholar 

  15. Pollock RG, Deliz ED, McIlveen SJ, Flatow EL, Bigliani LU. Prosthetic replacement in rotator cuff-deficient shoulders. J Shoulder Elbow Surg 1992;1: 173–186.

    Article  CAS  Google Scholar 

  16. Cofield RH. Shoulder arthrodesis and resection arthroplasty. Instr Course Lect 1985;34: 268–277.

    CAS  PubMed  Google Scholar 

  17. Werner CM, Steinmann PA, Gilbart M, Gerber C. Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the Delta III reverse-ball-and-socket total shoulder prosthesis. J Bone Joint Surg Am 2005;87 (7): 1476–1486.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Musculoskeletal Radiology/A21, Division of Radiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Hakan Ilaslan & Michael P. Recht

  2. Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA

    Joseph P. Iannotti

Authors
  1. Hakan Ilaslan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joseph P. Iannotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael P. Recht
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hakan Ilaslan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ilaslan, H., Iannotti, J.P. & Recht, M.P. Deltoid muscle and tendon tears in patients with chronic rotator cuff tears. Skeletal Radiol 36, 503–507 (2007). https://doi.org/10.1007/s00256-007-0279-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-007-0279-5

Keywords

Search

Navigation