Evaluation and fatty infiltration and muscular atrophy of the rotator cuff and its impact on functional shoulder status. A comparison of ultrasonography and MRI assessment: A pilot study
by Giurlani, Beatrice, M.S., MGH INSTITUTE OF HEALTH PROFESSIONS, 2010, 95 pages; 1479686

Abstract:

Study Design. Pilot exploratory study.

Objective. To determine the reliability of Ultrasound Imaging (USI) in fatty infiltration/muscle atrophy (FI/MA) as compared to Magnetic Resonance Imaging (MRI) findings and to assess the impact of these findings on functional shoulder status in patients with FI/MA in the rotator cuff (RC) muscles.

Methods. Subjects with positive finding on MRI for FI/MA were assessed for pain, range of motion, muscle performance and function, and integrity of the supraspinatus (SSP) and infraspinatus (ISP) muscles using USI.

Results. 8 subjects between the ages of 57 to 75 years (mean age ± SD, 67.25 ± 6.38 years), with RC tear and FI/MA participated in this study. In shoulders with moderate to severe FI on USI, the pennate pattern was absent and marked hyperechogenicity was present. Accuracy of USI for the diagnosis of FI of SSP muscle was 75% (6 of 8) compared to MRI. Accuracy of USI for ISP muscle FI was 50% (4 of 8) compared to MRI due to an overestimation in 25% (2 of 8) of the cases and an underestimation in the other 25% of the cases. Hand held dynamometer (HHD) means between the two upper extremities (UE) were statistically significant in external rotation (ER) (P = 0.0004) and abduction (P = 0.053). Paired t-tests showed that MMT means between two UEs were statistically significant for ER (P = 0.002) internal rotation (P= 0.001) abduction (P = 0.004). Both comparisons between MRI and USI means for FI in the SSP muscle and the ISP muscle showed no difference, thereby the MRI and USI were consistent, especially for the SSP muscle (R = 0.90, P = 0.0023).

Conclusions. Ultrasound imaging can be used to assess substantial FI in the RC muscles. A larger sample size with this study design is needed for a wider analysis to identify clinical correlations between FI/MA and functional shoulder status. This may assist health care providers in enhancing treatment objectives and overall prognosis.

Key words: muscle contraction, atrophy, fatty infiltration, shoulder, rotator cuff tear.
 
AdvisersReginald B. Wilcox, III; Tracy J. Brudvig
SchoolMGH INSTITUTE OF HEALTH PROFESSIONS
SourceMAI/ 49-01, p. , Sep 2010
Source TypeThesis
SubjectsPhysical therapy; Medicine; Medical imaging and radiology
Publication Number1479686
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