Fractures of the greater tuberosity presenting as rotator cuff abnormality: magnetic resonance demonstration.
BACKGROUND
To show that magnetic resonance imaging (MRI) can be useful to diagnose radiographically invisible greater tuberosity fractures in patients with clinical presentations suspicious for rotator cuff injury.


METHODS
Six patients with subtle greater tuberosity fractures who were sent for MRI because of possible rotator cuff tear are reviewed (age range, 27-51 years; mean, 40.5 +/- 8.4 years). Five of the patients recount direct trauma to their shoulders, whereas one noticed shoulder pain after a fall in which she fractured her ankle.


RESULTS
MRI showed an area of edema confined to the greater tuberosity with linear low signal extending through the tuberosity consistent with a fracture in all cases. Although five patients had a complete set of shoulder radiographs before MRI, these were interpreted as normal in all cases. Full-thickness rotator cuff tears were not present in any of the cases. All of the patients were treated conservatively with good results.


CONCLUSIONS
MRI can prevent unnecessary arthroscopy in patients clinically suspected of rotator cuff damage by showing subtle fractures of the greater tuberosity not visible on radiographs.
Reinus
W R
WR
Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri 63110, USA. reinus@totty.wustl.ed
Hatem
S F
SF
D000058:Accidental Falls; D000328:Adult; D003951:Diagnostic Errors; D005260:Female; D006688:Hockey / Q000293:injuries; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012399:Rotation; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D012784:Shoulder Fractures / Q000175:diagnosis* / Q000209:etiology; D012861:Skating / Q000293:injuries