Atrophy and Fatty Infiltration of the Supraspinatus Muscle: Sonography Versus MRI
Viviane Khoury1,
Étienne Cardinal2 and
Paul Brassard3
1 Department of Diagnostic Radiology, McGill University Health Center, Montreal
General Hospital, 1650 Cedar Ave., Montreal, QC H3G 1A4, Canada.
2 Department of Radiology, Hôpital St-Luc, Centre Hospitalier de
l'Université de Montréal, Montreal, QC, Canada.
3 Division of Clinical Epidemiology, McGill University Health Center, Montreal,
QC, Canada.
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Fig. 1A —Calculation of occupation ratio by MRI in two shoulders. Two
methods were used in each shoulder: using either lines (A and C)
or ellipse tool (B and D) on PACS console to outline contours of
supraspinatus muscle and those of its fossa, as shown on these sagittal
oblique T1-weighted images. Normal supraspinatus muscle (no atrophy) in
56-year-old woman. Using lines, occupation ratio is 3.45/5.61 cm2 =
0.61.
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Fig. 1B —Calculation of occupation ratio by MRI in two shoulders. Two
methods were used in each shoulder: using either lines (A and C)
or ellipse tool (B and D) on PACS console to outline contours of
supraspinatus muscle and those of its fossa, as shown on these sagittal
oblique T1-weighted images. Using ellipse method in same shoulder as in
A, occupation ratio is 3.41/5.72 cm2 = 0.60.
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Fig. 1C —Calculation of occupation ratio by MRI in two shoulders. Two
methods were used in each shoulder: using either lines (A and C)
or ellipse tool (B and D) on PACS console to outline contours of
supraspinatus muscle and those of its fossa, as shown on these sagittal
oblique T1-weighted images. Supraspinatus with severe atrophy in 68-year-old
woman. Using lines, occupation ratio is 2.04/5.53 cm2 = 0.37.
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Fig. 1D —Calculation of occupation ratio by MRI in two shoulders. Two
methods were used in each shoulder: using either lines (A and C)
or ellipse tool (B and D) on PACS console to outline contours of
supraspinatus muscle and those of its fossa, as shown on these sagittal
oblique T1-weighted images. Using ellipse method in same shoulder as in
C, occupation ratio is 2.11/6.08 cm2 = 0.35.
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Fig. 2B —Evaluation of supraspinatus fatty infiltration on MRI.
Sagittal oblique T1-weighted images show mild (B), moderate (C),
and severe (D) fatty infiltration in 75-year-old man, 67-year-old man,
and 68-year-old woman, respectively.
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Fig. 2C —Evaluation of supraspinatus fatty infiltration on MRI.
Sagittal oblique T1-weighted images show mild (B), moderate (C),
and severe (D) fatty infiltration in 75-year-old man, 67-year-old man,
and 68-year-old woman, respectively.
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Fig. 2D —Evaluation of supraspinatus fatty infiltration on MRI.
Sagittal oblique T1-weighted images show mild (B), moderate (C),
and severe (D) fatty infiltration in 75-year-old man, 67-year-old man,
and 68-year-old woman, respectively.
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Fig. 3A —Calculation of occupation ratio by sonography in healthy
50-year-old man (no atrophy or fatty infiltration of supraspinatus). SS =
supraspinatus muscle, t = trapezius muscle. Suprascapular notch
(arrow) is located in coronal oblique plane.
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Fig. 3B —Calculation of occupation ratio by sonography in healthy
50-year-old man (no atrophy or fatty infiltration of supraspinatus). SS =
supraspinatus muscle, t = trapezius muscle. At notch (arrows),
transducer is rotated 90°, reproducing Y (sagittal oblique) view of MRI.
Ellipse tool on sonography unit was used to calculate occupation ratio in same
fashion as for MRI. C = clavicle, Sc = scapular spine.
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Fig. 4A —Sonography and MR images of shoulder in 75-year-old man
(A and B, respectively), 59-year-old woman (C and
D, respectively), and another 75-year-old man (E and F,
respectively). Coronal sonograms (A and C) show muscle
(arrows, A and C) being mildly hyperechoic relative to
trapezius muscle (t) and pennate pattern that is effaced. Coronal T1-weighted
MR images (B and D) show mild fatty infiltration.
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Fig. 4B —Sonography and MR images of shoulder in 75-year-old man
(A and B, respectively), 59-year-old woman (C and
D, respectively), and another 75-year-old man (E and F,
respectively). Coronal sonograms (A and C) show muscle
(arrows, A and C) being mildly hyperechoic relative to
trapezius muscle (t) and pennate pattern that is effaced. Coronal T1-weighted
MR images (B and D) show mild fatty infiltration.
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Fig. 4C —Sonography and MR images of shoulder in 75-year-old man
(A and B, respectively), 59-year-old woman (C and
D, respectively), and another 75-year-old man (E and F,
respectively). Coronal sonograms (A and C) show muscle
(arrows, A and C) being mildly hyperechoic relative to
trapezius muscle (t) and pennate pattern that is effaced. Coronal T1-weighted
MR images (B and D) show mild fatty infiltration.
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Fig. 4D —Sonography and MR images of shoulder in 75-year-old man
(A and B, respectively), 59-year-old woman (C and
D, respectively), and another 75-year-old man (E and F,
respectively). Coronal sonograms (A and C) show muscle
(arrows, A and C) being mildly hyperechoic relative to
trapezius muscle (t) and pennate pattern that is effaced. Coronal T1-weighted
MR images (B and D) show mild fatty infiltration.
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Fig. 4E —Sonography and MR images of shoulder in 75-year-old man
(A and B, respectively), 59-year-old woman (C and
D, respectively), and another 75-year-old man (E and F,
respectively). Sonogram shows that supraspinatus muscle (arrows) is
markedly hyperechoic relative to trapezius muscle (t) and that its pennate
pattern is lost.
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Fig. 4F —Sonography and MR images of shoulder in 75-year-old man
(A and B, respectively), 59-year-old woman (C and
D, respectively), and another 75-year-old man (E and F,
respectively). Coronal oblique T1-weighted MR image of same patient as in
E shows severe fatty infiltration.
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Fig. 5A —Supraspinatus atrophy and fatty infiltration of different
grades. In both patients, 60-year-old woman (A and B) and
75-year-old woman (C and D), there is severe atrophy, with
occupation ratio of < 0.4. On sonograms, inner circle represents
supraspinatus muscle, and outer circle represents supraspinatus fossa.
Sagittal sonogram (A) shows normal echogenicity and pennate pattern,
and no fatty infiltration is present on MRI image (B).
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Fig. 5B —Supraspinatus atrophy and fatty infiltration of different
grades. In both patients, 60-year-old woman (A and B) and
75-year-old woman (C and D), there is severe atrophy, with
occupation ratio of < 0.4. On sonograms, inner circle represents
supraspinatus muscle, and outer circle represents supraspinatus fossa.
Sagittal sonogram (A) shows normal echogenicity and pennate pattern,
and no fatty infiltration is present on MRI image (B).
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Fig. 5C —Supraspinatus atrophy and fatty infiltration of different
grades. In both patients, 60-year-old woman (A and B) and
75-year-old woman (C and D), there is severe atrophy, with
occupation ratio of < 0.4. On sonograms, inner circle represents
supraspinatus muscle, and outer circle represents supraspinatus fossa.
Sagittal sonogram (C) shows marked hyperechogenicity and lost pennate
pattern; these findings confirmed severe fatty infiltration on MR image
(D).
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Fig. 5D —Supraspinatus atrophy and fatty infiltration of different
grades. In both patients, 60-year-old woman (A and B) and
75-year-old woman (C and D), there is severe atrophy, with
occupation ratio of < 0.4. On sonograms, inner circle represents
supraspinatus muscle, and outer circle represents supraspinatus fossa.
Sagittal sonogram (C) shows marked hyperechogenicity and lost pennate
pattern; these findings confirmed severe fatty infiltration on MR image
(D).
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