title: MR imaging of subscapularis tendon injury in the setting of anterior shoulder dislocation.
abstract: OBJECTIVE
  To evaluate the degree and location patterns of subscapularis tendon injury in patients with prior anterior shoulder dislocation (ASD).
  
  
  METHODS
  Forty-five consecutive MR shoulder examinations in patients with a history of ASD and 20 consecutive MR examinations in patients without prior dislocation were reviewed. Two readers assessed for the presence and location of tendinosis and tearing in the subscapularis tendon, which was divided into three segments: superior, middle, and inferior. The readers also documented the presence of anterior labral tears, osseous Bankart defects and Hill-Sachs lesions. Fisher's exact tests were performed to analyze the different types of pathology and their locations.
  
  
  RESULTS
  Subscapularis tendinosis, and partial thickness and full thickness tears were more common in patients with a history of ASD. Tendinosis was found in 60-64.4% of the dislocation patients compared with 40% of the non-dislocation group. When stratified by location, the middle and inferior thirds were the most commonly affected with statistical significance (p < 0.05) found in tearing of the inferior third. Anterior labral tears, osseous Bankart defects, and Hill-Sachs lesions were more common in the dislocation group with statistically significant associations with tendinosis in the middle and inferior thirds and tearing of the middle third (p < 0.05).
  
  
  CONCLUSIONS
  Our study suggests an association between middle and inferior subscapularis tendon pathology and prior anterior shoulder dislocation. Based on our results, careful MR assessment of the subscapularis tendon by the radiologist is indicated in the setting of ASD as injury of this structure can be symptomatic and may be amenable to treatment.
authors.affiliation: NYU Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003, USA. Soterios20@gmail.com
authors.forename: Soterios
authors.initials: S
authors.lastname: Gyftopoulos
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Carpenter
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kazam
authors.forename: James
authors.initials: J
authors.lastname: Babb
authors.forename: Jenny
authors.initials: J
authors.lastname: Bencardino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012783:Shoulder Dislocation / Q000473:pathology*; D052256:Tendinopathy / Q000473:pathology*; D013708:Tendon Injuries / Q000473:pathology*