2017 ISAKOS Biennial Congress ePoster #2212
The Clinical Characteristics of Isolated Infraspinatus Tear and the Usefulness of the Infraspinatus View on MRI
Kyoung-Jin Park, MD, PhD, Cheongju, Chungbuk KOREA, REPUBLIC OF
Yong-Min Kim, MD, Cheongju, Chungbuk KOREA, REPUBLIC OF
Byung-Ki Cho, MD, Cheongju, Chungbuk KOREA, REPUBLIC OF
Donghwan Kim, MD, Cheongju, Chungbuk KOREA, REPUBLIC OF
Jae Young Yang, Cheongju, Province: Chungbuk KOREA, REPUBLIC OF
Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju , Chungbuk , KOREA, REPUBLIC OF
FDA Status Cleared
Summary
It is difficult to detect an isolated IST tear with conventional MRI; early diagnosis can be made by using MRI with IST view in patients who are suspected with having isolated IST tear.
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Abstract
Purpose
Prevalence of isolated infraspinatus(IST) tear of shoulder is very rare and early diagnosis of the tear is difficult; diagnosis and treatment for tear is usually delayed. As a result, the prognosis of isolated infraspinatus tear is poor and fatty atrophy of IST is irreversible. The purpose of this study is to evaluate the clinical characteristics of the isolate IST tear and usefulness of the IST view on MRI.
Methods
and materials: From May 2014 to March 2016, total 13 patients who were diagnosed with IST tear on IST view MRI were prospectively studied. The detection ratios of isolate IST tear using conventional MRI versus MRI with IST view were investigated. After surgery, repair integrity of IST was evaluated with follow up MRI, and recovery of shoulder function was estimated by KSS score, Constant score, and ASES score. IST view of MRI was beamed by 45 degrees tilted from the axial view and parallel to the IST muscle fibers in the coronal plane.
Result: Total 13 patients were confirmed with isolated IST tear on MRI with IST view. There were 3 males and 10 females among the patients. Dominant arm was involved in 8 patients, and non-dominant arm was involved in 5 patients. 2 patients had tear with history of trauma, but 11 patients had no obvious history of trauma. Total 10 patients got the operation; 8 patients had partial thickness IST tear, and 2 patients had complete tear. On conventional MRI, muscle atrophy was observed in all of the 13 patients, however IST tear was observed in only 4 patients. In contrast, on MRI with IST view, both muscle atrophy and tear were observed in all patients on the same view. Follow up MRI were taken from the 8 patients; the healing of the tendon was successful, but IST muscle atrophy was not recovered.
Conclusion
On the Follow-up MRI after isolated IST repair, the healing of IST tendon repair was successful, but fatty atrophy of IST was irreversible. Therefore, it is important to get an early diagnosis of the IST tear before the muscle atrophy occurs. However, it is difficult to detect an isolated IST tear with conventional MRI; early diagnosis can be made by using MRI with IST view in patients who are suspected with having isolated IST tear.