Gwark Ji-Yong, Park Tae-Soo, Park Hyung Bin
1 Department of Orthopaedic Surgery, School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
2 Department of Orthopaedic Surgery, College of Medicine, Hanyang University, Republic of Korea.
J Orthop Surg (Hong Kong). 2019 Jan-Apr;27(1):2309499019825762. doi: 10.1177/2309499019825762.
The association between tuberosity cysts and rotator cuff tears (RCTs) and the nature of the major contributing factors to tuberosity cyst formation continue to be controversial. The purpose of our study was to evaluate the strength of associations of RCT and various factors involved in the chronicity of RCT with tuberosity cysts, using magnetic resonance imaging (MRI) and radiographs.
We reviewed consecutive patients with various disease entities between August 2004 and July 2013. After excluding unsuitable patients, this study involved 1007 shoulders of 906 consecutive patients. Each tuberosity cyst was categorized as an anterior greater tuberosity (GT), posterior GT, lesser tuberosity, and bare-area cyst. The odds ratios (ORs) and 95% confidence intervals (CIs) between the tuberosity cysts and various factors were evaluated by logistic regression analyses; p-value was set below 0.05.
Anterior GT cysts and posterior GT cysts on MRI or anterior GT cysts on radiographs were significantly associated with supraspinatus tendon (SST) tears ( p ≤ 0.019) and infraspinatus tendon (IST) tears ( p ≤ 0.004). Among the shoulder pathologies, RCTs only significantly associated with cyst formation (OR 4.23, 95% CI 3.17-5.65; p < 0.001). The retraction grade of Patte was significantly associated with anterior GT cyst (OR 3.65, 95% CI 2.42-5.48; p < 0.001).
Detecting an anterior GT cyst in a radiograph, even a low prevalence, in a patient with symptomatic shoulder indicates a need to consider RCT, especially of the SST, IST, and a high possibility of a retracted tear.
结节囊肿与肩袖撕裂（RCT）之间的关联以及结节囊肿形成的主要促成因素的性质一直存在争议。我们研究的目的是使用磁共振成像（MRI）和X线片评估RCT及RCT慢性化所涉及的各种因素与结节囊肿之间关联的强度。
我们回顾了2004年8月至2013年7月期间患有各种疾病实体的连续患者。在排除不合适的患者后（此处原英文有误，应是“在排除不适合的患者后”），本研究纳入了906例连续患者的1007个肩部。每个结节囊肿被分类为前侧大结节（GT）囊肿、后侧GT囊肿、小结节囊肿和裸区囊肿。通过逻辑回归分析评估结节囊肿与各种因素之间的比值比（OR）和95%置信区间（CI）；p值设定为低于0.05。
MRI上的前侧GT囊肿和后侧GT囊肿或X线片上的前侧GT囊肿与冈上肌腱（SST）撕裂（p≤0.019）和冈下肌腱（IST）撕裂（p≤0.004）显著相关。在肩部病变中，只有RCT与囊肿形成显著相关（OR 4.23，95%CI 3.17 - 5.65；p<0.001）（此处原英文有误，应是“只有RCT与囊肿形成显著相关（比值比4.23，95%置信区间3.17 - 5.65；p<0.001）”）。Patte回缩分级与前侧GT囊肿显著相关（OR 3.65，95%CI 2.42 - 5.48；p<0.001）。
对于有症状肩部的患者，即使在X线片上检测到前侧GT囊肿的患病率较低，也表明需要考虑RCT，尤其是SST、IST的RCT，以及存在回缩性撕裂的高可能性。
