title: The supraspinatus distension sign: an indicator of supraspinatus integrity.
abstract: OBJECTIVE
  To determine if direct contact between the biceps tendon and supraspinatus in patients undergoing shoulder arthroscopy performed in the lateral decubitus position has predictive value in evaluating full-thickness and articular-sided, partial-thickness rotator cuff tears.
  
  
  METHODS
  Five hundred sixty-three consecutive shoulder arthroscopies in the lateral decubitus position were performed by a single surgeon between September 2005 and September 2007. The presence or absence of distance between the biceps tendon and supraspinatus was evaluated upon entering the joint. A diagnostic arthroscopy of the glenohumeral and subacromial spaces then ensued to determine the presence and extent of rotator cuff tear.
  
  
  RESULTS
  The biceps-supraspinatus interval was preserved in 211 of 232 (90.9%) of the articular-sided, partial-thickness tears. The biceps-supraspinatus space was absent in 76 of 77 (98.7%) of the full-thickness tears. After excluding cases of concomitant adhesive capsulitis, all 211 articular-sided, partial-thickness rotator cuff tears and only 1 of 75 (1.3%) full-thickness rotator cuff tears was associated with a preserved biceps-supraspinatus interval (false negative).
  
  
  CONCLUSIONS
  Our study further validates the high sensitivity and specificity of using the loss of supraspinatus distension for predicting full-thickness rotator cuff tears. We also report the reliable preservation of supraspinatus distension with articular-sided, partial-thickness rotator cuff tears. These articular-sided partial-thickness tears typically do not lead to sufficient egress of arthroscopic fluid from the glenohumeral joint to cause a loss of supraspinatus distension.
  
  
  METHODS
  Level IV, prognostic case series.
authors.affiliation: Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California, USA.
authors.forename: Gregory H
authors.initials: GH
authors.lastname: Lee
authors.forename: Benjamin T
authors.initials: BT
authors.lastname: Busfield
authors.forename: Mike
authors.initials: M
authors.lastname: Carrillo
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Ortega
authors.forename: F Daniel
authors.initials: FD
authors.lastname: Kharrazi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D017006:Rotator Cuff / Q000473:pathology* / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D055815:Young Adult