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Rotator Cuff Muscle Evaluation

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Okay, we've been talking about the rotator cuff and

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its six major components: supraspinatus,

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infraspinatus, teres minor, subscapularis,

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coracohumeral ligament, and capsule.

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We've also been talking about the arches,

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the lateral arch underneath the acromion,

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the medial arch underneath the AC joint,

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and the subcoracoid or anterior arch,

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which can damage or injure the lesser tuberosity,

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the biceps, and the subscapularis,

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the forgotten arch.

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But I'm here to talk about the muscular tissue.

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The muscular tissue that dynamically helps

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support the stabilization of the shoulder.

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Whereas the rotator cuff is a static stabilizer.

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The muscles can be divided up into their

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individual anatomic muscles,

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supraspinatus,

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infraspinatus, teres minor, subscapularis.

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But also, the most important,

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distinction in evaluating muscles in the rotator cuff is

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whether they are volumetrically decreased

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and whether they have fatty infiltration.

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And of the two,

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fatty infiltration is worse,

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because if you have fatty infiltration, it's very hard to pull

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that tendon and muscle over and fix it.

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You'll probably shred it.

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So many of those individuals who have severe

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fatty infiltration are not candidates for surgery.

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Now, volumetrically,

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I will admit that that is subjective evaluation,

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for instance,

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this supra and infraspinatus.

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There should be only slits of fat left.

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So I would call this moderate to marked,

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or at least moderate.

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And the amount of fatty infiltration can be

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compared with the trapezius

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to use it as a reference point.

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And I would say there's at least mild,

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perhaps to moderate fatty infiltration.

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But I always try to make that

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distinction for the surgeon.

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Most important is when it's volumetrically severe,

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and even more important than that,

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when the fatty infiltration is severe.

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Those patients are often unsuitable for surgery.

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The.

Report

Description

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Tags

Trauma

Shoulder

Musculoskeletal (MSK)

MRI

Bone & Soft Tissues

Acquired/Developmental

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