Department of Radiology, Veterans Health Service Medical Center, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul 05368, Republic of Korea.
Department of Radiology, Graduate School of Chung-Ang University, Seoul, Republic of Korea.
AJR Am J Roentgenol. 2020 May;214(5):1146-1151. doi: 10.2214/AJR.19.21973. Epub 2020 Feb 18.
The objective of our study was to evaluate the relationship between stiff shoulder in patients with a full-thickness rotator cuff tear and MRI findings, especially joint capsule abnormality. This study included 106 patients with small to large (≤ 5 cm) full-thickness rotator cuff tears. Joint capsule edema and thickness in the axillary recess, obliteration of the subcoracoid fat triangle, fatty degeneration of the torn rotator cuff muscle, and degree of retraction were assessed by two radiologists. The size and location of tears were determined by MRI findings and operative report. Associations between MRI findings and preoperative passive range of motion (ROM) were assessed by simple and multiple linear regression analyses and proportional odds logistic regression analysis. There was a significant, negative linear correlation between limited ROM at forward elevation and thickness of the joint capsule in the glenoid portion of the axillary recess ( = 0.018), external rotation and joint capsule edema in the humeral portion of the axillary recess ( = 0.011), and internal rotation and joint capsule edema in the glenoid portion of the axillary recess ( = 0.007). Male sex ( = 0.041) and posterosuperior rotator cuff tear ( = 0.030) were independent predictors of shoulder ROM on external rotation. Degree of fatty degeneration ( = 0.003) was another independent predictor of shoulder ROM on internal rotation. MRI findings-especially joint capsule edema and thickness at the axillary recess-can be useful in predicting shoulder stiffness in patients with rotator cuff tear.
我们的研究目的是评估肩袖全层撕裂患者中僵硬肩与 MRI 发现之间的关系，尤其是关节囊异常。本研究纳入了 106 例大小（≤ 5cm）不同的肩袖全层撕裂患者。两名放射科医生评估了腋隐窝关节囊水肿和厚度、喙突下脂肪三角消失、撕裂肩袖肌肉的脂肪变性以及回缩程度。通过 MRI 发现和手术报告确定撕裂的大小和位置。通过简单和多元线性回归分析以及比例优势逻辑回归分析评估 MRI 发现与术前被动活动范围（ROM）之间的相关性。前屈ROM 受限与腋隐窝肩胛部分关节囊厚度（ = 0.018）、外旋ROM 与腋隐窝肱骨部分关节囊水肿（ = 0.011）、内旋ROM 与腋隐窝肩胛部分关节囊水肿（ = 0.007）之间存在显著的负线性相关。男性（ = 0.041）和肩袖后上方撕裂（ = 0.030）是外旋ROM 的独立预测因素。肩袖脂肪变性程度（ = 0.003）是内旋 ROM 的另一个独立预测因素。MRI 发现——尤其是腋隐窝处的关节囊水肿和厚度——可以为肩袖撕裂患者的肩部僵硬提供有用的预测。
