CT での小結節内骨嚢腫は肩甲下筋腱断裂を強く示唆する

概要

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Background: It is difficult to diagnose the subscapularis tendon tears preoperatively. The purpose of our study was to evaluate the relationship between the subscapularis tendon tears and the bone cysts in the lesser tuberosity on CT. Methods: We evaluated 107 shoulders (64 males and 43 females, 68 right and 39 left shoulders) who had both CT arthrography and arthroscopic rotator cuff repairs performed. Their average age was 64.4 (35-83) years old. The cysts were evaluated with both transverse and parasagital images on CT arthrography. Results: Bone cysts in the lesser tuberosity were identified in 27 of 107 shoulders (25.2%). The arthroscopic findings showed subscapularis tendon tears in 57 shoulders (53.3%) which included 29 articular-sided tears, 1 bursal-sided tear, 27 complete tears. With regard to the relationship between subscapularis tendon tears and the bone cysts in the lesser tuberosity on CT, the sensitivity was 40.4%, the specificity was 92.0%, the accuracy was 64.5%, the positive predictive value was 85.2%, and the negative predictive value was 57.5%. Conclusion: The presence of bone cysts in the lesser tuberosity on CT strongly suggested subscapularis tendon tears. CT or CT arthrography is useful for preoperative diagnosis of subscapularis tendon tears.