腱板不全断裂・関節面側断裂と滑液包側断裂の鑑別診断

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We compared the preoperative clinical and MRI findings between incomplete joint side tears (Group A) and incomplete bursal side tears (Group B), and investigated the possibility of the preoperative diagnosis of the incomplete tear side. Ten shoulders of 10 patients who were diagnosed as having incomplete rotator cuff tear by arthroscopy and macroscopic observation were examined. Group A consisted of five shoulders, and Group B five shoulders. Occupation, age, duration of the disease, past history of injury, pain, click, and MRI findings were compared among 2 groups. Many had occupations that palced a burder on their shoulders in Group B. The age was significantly higher in Group A. There was no significant difference in the duration of the disease. Group A had two shoulders with a past history of injury and Group B had one. The night pain was milder in Group B than that in Group A. Motion pain was higher in Group B than that in Group A. On preoperative MRIs, although the subacromial bursal edema was detected in all patients in both groups, the continuity of the tendon was retained. However, bone cyst was observed near the tendon attachment site in four shoulders in Group A, while there was no bone cyst in Group B. Group A was characterized as following : 1. physical activity was relatively high, as in the young, 2. patients mainly had motion pain rather than night pain, 3. clear clicking was observed, and 4. subacromial bursal edema was odserved on preoperative MRIs. While, group B was characterized as following : 1. aged patients, 2. patients mainly had night pain rather than motion pain, and 3. bone cyst of the humeral head was observed on preoperative MRI.
日本肩関節学会の論文

腱板不全断裂・関節面側断裂と滑液包側断裂の鑑別診断

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