Alharbi Abdulrahman, Alsaadi Mohammed J, Alfuraih Abdulrahman M, Almalki Mamdouh S, Bauones Salem
Medical Imaging Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Radiology and Medical Imaging Department, College of Applied Medical Sciences in Al-Kharj, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia.
Ann Med Surg (Lond). 2022 Sep 11;82:104621. doi: 10.1016/j.amsu.2022.104621. eCollection 2022 Oct.
Full-thickness rotator cuff tear is common in the older population. The incidence of traumatic deltoid tears post-surgery is well addressed. However, non-traumatic spontaneous injury is not well recognized despite a few case reports and previous studies. The aim of the study is to determine the incidence and association of deltoid tear among patients with non-traumatic full-thickness rotator cuff tear using shoulder magnetic resonance imaging.
A retrospective cross-sectional study was conducted of 271 shoulders magnetic resonance imaging examinations with full-thickness rotator cuff tear between 2012 and 2022. The analyzed variables were full-thickness rotator cuff tear size, tear grading (small, medium, large, and massive), muscle fatty degeneration, and deltoid tear. Acromio-humeral interval was also recorded and analyzed on the anteroposterior projection of shoulder radiographs.
The incidence of deltoid tear was 7% (19 cases), encountered in eleven females (6.4%) and eight males (8%) with a mean age of 65 years. Deltoid tears were located on the right side in fifteen patients (9.4%) and on the left side in four patients (3.6%). The Man-Whitney test indicated a significant association between deltoid tears and full-thickness rotator cuff tear, P < 0.001. The deltoid tear was more notably associated with large and massive full-thickness rotator cuff tear (16.7% and 42.3%, respectively), P < 0.001. Acromio-humeral interval showed a significant difference between the deltoid and non-deltoid cases, P = 0.045.
The incidence and association of deltoid tears with full-thickness rotator cuff tear with no prior surgical intervention or traumatic insults were considered significant, with a positive impact of large and massive tear size and association of muscle fatty degeneration. This association is statistically significant and should be adequately evaluated by the radiologist.
全层肩袖撕裂在老年人群中很常见。术后创伤性三角肌撕裂的发生率已有充分研究。然而，尽管有一些病例报告和先前的研究，但非创伤性自发性损伤尚未得到充分认识。本研究的目的是使用肩部磁共振成像确定非创伤性全层肩袖撕裂患者中三角肌撕裂的发生率及相关性。
对2012年至2022年间271例肩部磁共振成像检查显示全层肩袖撕裂的患者进行回顾性横断面研究。分析的变量包括全层肩袖撕裂大小、撕裂分级（小、中、大、巨大）、肌肉脂肪变性和三角肌撕裂。还记录并分析了肩部X线前后位片上的肩峰-肱骨头间距。
三角肌撕裂的发生率为7%（19例），其中11名女性（6.4%）和8名男性（8%），平均年龄65岁。15例患者（9.4%）的三角肌撕裂位于右侧，4例患者（3.6%）位于左侧。曼-惠特尼检验表明三角肌撕裂与全层肩袖撕裂之间存在显著相关性，P < 0.001。三角肌撕裂与大及巨大全层肩袖撕裂的相关性更显著（分别为16.7%和42.3%），P < 0.001。肩峰-肱骨头间距在三角肌撕裂与无三角肌撕裂的病例之间存在显著差异，P = 0.045。
在无先前手术干预或创伤性损伤的情况下，三角肌撕裂与全层肩袖撕裂的发生率及相关性被认为具有显著性，大及巨大撕裂大小以及肌肉脂肪变性与之相关具有积极影响。这种相关性具有统计学意义，放射科医生应进行充分评估。
