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Association Between Rotator Cuff Abnormalities and Reduced Acromiohumeral Distance

Nadja Saupe1, Christian W. A. Pfirrmann1, Marius R. Schmid1, Bernhard Jost2, Clément M. L. Werner2 and Marco Zanetti1

1 Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland.
2 Department of Orthopedic Surgery, Orthopedic University Hospital Balgrist, CH-8008 Zurich, Switzerland.


Figure 1
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  		Fig. 1A —69-year-old woman with large rotator cuff tear of left shoulder and substantial fatty muscle degeneration in association with reduced acromiohumeral distance. Conventional anteroposterior radiograph shows reduced acromiohumeral distance (arrows) of 2.7 mm.

 

Figure 2
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  		Fig. 1B —69-year-old woman with large rotator cuff tear of left shoulder and substantial fatty muscle degeneration in association with reduced acromiohumeral distance. Conventional radiograph in supraspinatus outlet view shows reduced acromiohumeral distance (arrows) of 3.9 mm.

 

Figure 3
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  		Fig. 1C —69-year-old woman with large rotator cuff tear of left shoulder and substantial fatty muscle degeneration in association with reduced acromiohumeral distance. T1-weighted MR arthrograms show large full-thickness tear (arrowheads) of supraspinatus, infraspinatus, and subscapularis tendons. Acromiohumeral distance (arrows) of 1 mm in coronal (TR/TE, 792/20) projection (C) and of 1.2 mm in sagittal oblique (500/30) projection (D) are smaller than distances in A and B.

 

Figure 4
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  		Fig. 1D —69-year-old woman with large rotator cuff tear of left shoulder and substantial fatty muscle degeneration in association with reduced acromiohumeral distance. T1-weighted MR arthrograms show large full-thickness tear (arrowheads) of supraspinatus, infraspinatus, and subscapularis tendons. Acromiohumeral distance (arrows) of 1 mm in coronal (TR/TE, 792/20) projection (C) and of 1.2 mm in sagittal oblique (500/30) projection (D) are smaller than distances in A and B.

 

Figure 5
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  		Fig. 1E —69-year-old woman with large rotator cuff tear of left shoulder and substantial fatty muscle degeneration in association with reduced acromiohumeral distance. T1-weighted sagittal oblique image shows fatty degeneration of supraspinatus (SSP) (Goutallier stage 4 [6]), infraspinatus (ISP) (Goutallier stage 4), and subscapularis (SSC) muscles (Goutallier stage 3). Residual supraspinatus muscle does not cross tangent (dashed line) through superior borders of scapular spine or superior margin of coracoid ("tangent sign" present). Presence of tangent sign indicates supraspinatus atrophy.

 

Figure 6
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  		Fig. 2A —38-year-old man with small full-thickness tear in right supraspinatus tendon. No substantial fatty muscle degeneration is seen, and acromiohumeral distance is normal. Conventional anteroposterior radiographs shows normal acromiohumeral distance (arrows) of 9.5 mm.

 

Figure 7
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  		Fig. 2B —38-year-old man with small full-thickness tear in right supraspinatus tendon. No substantial fatty muscle degeneration is seen, and acromiohumeral distance is normal. Conventional radiograph in supraspinatus outlet view shows normal acromiohumeral distance (arrows) of 10.0 mm.

 

Figure 8
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  		Fig. 2C —38-year-old man with small full-thickness tear in right supraspinatus tendon. No substantial fatty muscle degeneration is seen, and acromiohumeral distance is normal. Coronal oblique (C) (TR/TE, 792/20) and sagittal oblique (D) (500/30) T1-weighted MR arthrograms show small full-thickness tear (arrows) of supraspinatus tendon.

 

Figure 9
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  		Fig. 2D —38-year-old man with small full-thickness tear in right supraspinatus tendon. No substantial fatty muscle degeneration is seen, and acromiohumeral distance is normal. Coronal oblique (C) (TR/TE, 792/20) and sagittal oblique (D) (500/30) T1-weighted MR arthrograms show small full-thickness tear (arrows) of supraspinatus tendon.

 

Figure 10
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  		Fig. 2E —38-year-old man with small full-thickness tear in right supraspinatus tendon. Rotator cuff muscles and acromiohumeral distance are normal. T1-weighted sagittal oblique image shows no fatty degeneration of supraspinatus (SSP) or subscapularis (SSC) muscle (Goutallier stage 0 [6]). Small amount of fatty degeneration (Goutallier stage 1) is present in infraspinatus (ISP) muscle. Normal supraspinatus muscle crosses tangent (dashed line), connecting superior borders of scapular spine and superior margin of coracoid ("tangent sign" absent).

 

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