Rotator Cuff Muscle Evaluation
HIDEInteractive Transcript
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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.
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
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