Suluova Fatih, Kanatli Ulunay, Ozturk Burak Yagmur, Esen Erdinc, Bolukbasi Selcuk
Orthopedics and Traumatology Clinic, Sungurlu State Hospital, Corum, Turkey.
Eur J Orthop Surg Traumatol. 2014 Jul;24(5):733-9. doi: 10.1007/s00590-013-1247-5. Epub 2013 Jun 9.
The objective of this study was to retrospectively evaluate the prevalence of the cystic changes at rotator cuff footprint on proximal humeral tuberosities and investigate their relationship with rotator cuff tears and patient age. Magnetic resonance (MR) images of 657 patients who underwent shoulder arthroscopy for treatment of rotator cuff disorders were reviewed to localize the cystic changes at anterior (supraspinatus insertion) and posterior (infraspinatus insertion) aspects of greater tuberosity (GT) and lesser tuberosity (subscapularis insertion). Preoperative MR reports as well as cyst size and locations on MR images were correlated with arthroscopic records of rotator cuff pathology (tear type, size, location and tendon involvement) and patient age. The prevalence of cystic changes was 9.1% (60 patients) in the study population. Anterior GT cysts were found in 56% of patients and were strongly associated with full-thickness (p<.001) and articular-sided partial-thickness rotator cuff tears (p=.02). Posterior GT and lesser tuberosity cysts were found in 27 and 17% of patients, respectively, and were not significantly related to rotator cuff tears, although there was an increased trend of posterior cysts in patients with infraspinatus tears (p=.09). A significant relation was found between patient age and the cyst size (p=.01), while none of the cyst localizations were statistically related to age. Anterior GT cysts were more common in this patient group and demonstrated a strong association with rotator cuff disorders regardless of age. Posterior GT and lesser tuberosity cysts were less common and showed no association with rotator cuff pathology or patient age.
本研究的目的是回顾性评估肱骨近端结节处肩袖附着点囊性变的患病率，并探讨其与肩袖撕裂和患者年龄的关系。回顾了657例行肩关节镜检查治疗肩袖疾病患者的磁共振（MR）图像，以确定在大结节（GT）前侧（冈上肌附着点）和后侧（冈下肌附着点）以及小结节（肩胛下肌附着点）的囊性变情况。术前MR报告以及MR图像上囊肿的大小和位置与肩袖病理的关节镜记录（撕裂类型、大小、位置和肌腱受累情况）及患者年龄相关。研究人群中囊性变的患病率为9.1%（60例患者）。56%的患者发现有大结节前侧囊肿，且与全层（p<0.001）和关节侧部分厚度肩袖撕裂（p=0.02）密切相关。分别有27%和17%的患者发现有大结节后侧和小结节囊肿，尽管冈下肌撕裂患者后侧囊肿有增加趋势（p=0.09），但这些囊肿与肩袖撕裂无显著相关性。发现患者年龄与囊肿大小之间存在显著关系（p=0.01），而囊肿的位置与年龄均无统计学关联。大结节前侧囊肿在该患者组中更常见，且无论年龄大小均与肩袖疾病密切相关。大结节后侧和小结节囊肿较少见，且与肩袖病理或患者年龄无关。
