ABSTRACTThe objective of this paper is to present a review of the role of magnetic resonance imaging in the evaluation of shoulder impingement syndrome and rotator cuff tendon tears. This imaging modality is effective in demonstrating both the soft tissue and bony abnormalities associated with structural shoulder impingement which include subacromial-subdeltoid bursitis, supraspinatus tendinopathy, rotator cuff tendon tears, subacromial osteophytic spurs and acromioclavicular joint capsular hypertrophy and osteophytosis. The detection of a subacromial osteophytic spur is considered specific for shoulder impingement syndrome. The 3 most accurate magnetic resonance imaging signs of a full thickness supraspinatus tendon tear reported are: tendon discontinuity, musculotendinous junction retraction and supraspinatus tendon thinning. The most specific sign is tendon discontinuity and the most sensitive is subacromial-subdeltoid bursal fluid.
In the evaluation of chronic shoulder pain and dysfunction clinically suspected to be due to shoulder impingement syndrome and rotator cuff tendon tears, magnetic resonance imaging (MRI) has virtually replaced double contrast shoulder arthrography. MRI has the advantage of demonstrating the shoulder joint in multiple anatomical planes with excellent tissue contrast resolution.
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