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Rim-Rent Tear of the Rotator Cuff: A Common and Easily Overlooked Partial Tear

¹ Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.
² Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA 02115.

View larger version (141K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —25-year-old man with rim-rent tear of supraspinatus tendon. Fat-suppressed fast spin-echo T2-weighted coronal oblique (TR/TE, 3,967/65) (A) and sagittal oblique (3,850/75) (B) MR arthrography images show rim-rent tear (arrows) at insertion of supraspinatus tendon onto greater tuberosity.

View larger version (126K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —25-year-old man with rim-rent tear of supraspinatus tendon. Fat-suppressed fast spin-echo T2-weighted coronal oblique (TR/TE, 3,967/65) (A) and sagittal oblique (3,850/75) (B) MR arthrography images show rim-rent tear (arrows) at insertion of supraspinatus tendon onto greater tuberosity.

View larger version (165K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —38-year-old man with rim-rent tear of infraspinatus tendon. Fat-suppressed fast spin-echo T2-weighted coronal oblique (TR/TE, 4,000/65) (A) and sagittal oblique (3,000/74) (B) MR arthrography images show rim-rent tear (arrows) at insertion of infraspinatus tendon onto greater tuberosity. This tear was not seen prospectively but was diagnosed at time of surgery.

View larger version (154K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —38-year-old man with rim-rent tear of infraspinatus tendon. Fat-suppressed fast spin-echo T2-weighted coronal oblique (TR/TE, 4,000/65) (A) and sagittal oblique (3,000/74) (B) MR arthrography images show rim-rent tear (arrows) at insertion of infraspinatus tendon onto greater tuberosity. This tear was not seen prospectively but was diagnosed at time of surgery.

View larger version (167K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —56-year-old man with rim-rent tear of anterior fibers of supraspinatus tendon; patient positioned in internal rotation. Fat-suppressed fast spin-echo T2-weighted coronal oblique (TR/TE, 4,000/67) (A) and sagittal oblique (4,000/67) (B) MR images show rim-rent tear at insertion of supraspinatus tendon onto greater tuberosity involving insertion of far anterior fibers of supraspinatus tendon (arrows) adjacent to biceps tendon (arrowhead, A). This tear was not diagnosed at time of initial MRI interpretation.

View larger version (160K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —56-year-old man with rim-rent tear of anterior fibers of supraspinatus tendon; patient positioned in internal rotation. Fat-suppressed fast spin-echo T2-weighted coronal oblique (TR/TE, 4,000/67) (A) and sagittal oblique (4,000/67) (B) MR images show rim-rent tear at insertion of supraspinatus tendon onto greater tuberosity involving insertion of far anterior fibers of supraspinatus tendon (arrows) adjacent to biceps tendon (arrowhead, A). This tear was not diagnosed at time of initial MRI interpretation.

View larger version (144K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4 —58-year-old woman with critical zone partial-thickness tear. Coronal oblique fat-suppressed fast spin-echo T2-weighted (TR/TE, 4,000/67) MR image shows partial-thickness, articular-sided tear of supraspinatus tendon 1–2 cm proximal to its insertion, in so-called critical zone (arrow).

View larger version (159K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5 —46-year-old man with full-thickness rotator cuff tear. Coronal oblique fat-suppressed fast spin-echo T2-weighted (TR/TE, 4,000/66) MR arthrography image shows full-thickness tear of rotator cuff from insertion on greater tuberosity (arrow).

View larger version (141K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6A —36-year-old man with normal supraspinatus anterior fibers. Consecutive far anterior coronal oblique fat-suppressed fast spin-echo T2-weighted (TR/TE, 4,000/67) MR arthrography images show normal appearance of anterior fibers of rotator cuff insertion (thick arrows) adjacent to long head of biceps tendon (thin arrows).

View larger version (143K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6B —36-year-old man with normal supraspinatus anterior fibers. Consecutive far anterior coronal oblique fat-suppressed fast spin-echo T2-weighted (TR/TE, 4,000/67) MR arthrography images show normal appearance of anterior fibers of rotator cuff insertion (thick arrows) adjacent to long head of biceps tendon (thin arrows).

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