title: Use of preoperative magnetic resonance imaging to predict rotator cuff tear pattern and method of repair.
abstract: OBJECTIVE
  To determine the magnetic resonance imaging (MRI) criteria for predicting rotator cuff tear pattern and method of repair.
  
  
  METHODS
  Retrospective MRI/arthroscopy correlation.
  
  
  METHODS
  Sixty-six preoperative MRI scans were evaluated. The maximum medial to lateral length (L) of the tear was measured on T2-weighted coronal cuts. The maximum anterior to posterior width (W) was measured on T2-weighted sagittal cuts. The cases were divided into 3 groups: group 1, short-wide tears, L < or = W, L < 2 cm; group 2, long-narrow tears, L > W, W < 2 cm; and group 3, long-wide tears, L > or = 2 cm, W > or = 2 cm.
  
  
  RESULTS
  Of the 66 MRI scans, 55 were adequate for standardized measurement. Group 1, 16 cases: 15 were found at arthroscopy to be crescent-shaped tears repaired end-to-bone; 1 was repaired with interval slides. Group 2, 22 cases: all 22 were repaired side-to-side/margin convergence. Group 3, 17 cases: 12 required interval slides, 1 partial repair was performed, and 4 were repaired side-to-side/margin convergence.
  
  
  CONCLUSIONS
  Tear pattern and method of repair can be predicted on high-quality MRI scan. Group 1, L < or = W and L < 2 cm, predicts a crescent-shaped tear and end-to-bone repair (positive predictive value, 93.8%). Group 2, L > W and W < 2 cm, predicts a longitudinal tear and side-to-side/margin convergence repair (positive predictive value 100%). Group 3, L > or = 2 cm and W > or = 2 cm, predicts a massive contracted tear and that primary end-to-bone or side-to-side repairs are usually not possible and that interval slides or partial repair may be necessary (positive predictive value, 76.5%). The overall diagnostic model based on usable MRI scans significantly predicted arthroscopic findings (P < .001 for chi-square test).
  
  
  METHODS
  Level III, development of diagnostic criteria with universally applied reference (nonconsecutive patients).
authors.affiliation: Canyon Orthopaedic Surgeons, Phoenix, Arizona, USA. Shoulders@pol.net
authors.forename: J F James
authors.initials: JF
authors.lastname: Davidson
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Burkhart
authors.forename: David P
authors.initials: DP
authors.lastname: Richards
authors.forename: Scot E
authors.initials: SE
authors.lastname: Campbell
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry / Q000379:methods; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000473:pathology / Q000601:surgery; D000070636:Rotator Cuff Injuries