title: True anteroposterior (Grashey) view as a screening radiograph for further imaging study in rotator cuff tear.
abstract: BACKGROUND
  Although findings of conventional radiography seem nonspecific, it is still the first imaging modality used to evaluate patients with rotator cuff tears. The purpose of this study is to determine whether the true anteroposterior (AP) view of the glenohumeral (GH) joint (the thorax is rotated to the affected shoulder for 35°-45°) is more sensitive than the conventional shoulder AP view (the beam and cassette are perpendicular to the torso but oblique to the glenohumeral joint) in terms of detecting rotator cuff tears.
  
  
  METHODS
  Intermixed GH AP and conventional AP views of 160 consecutive shoulders, which were repaired by arthroscopic surgery, were reviewed in a blinded fashion. The detection rate of 5 pathognomonic signs for rotator cuff tear were determined by use of both radiographs: greater tuberosity (GT) sclerosis, GT osteophyte, subacromial (SA) osteophyte, GT cyst, and humeral head osteophyte. An additional comparison according to the tear size was performed.
  
  
  RESULTS
  The detection of all radiographic findings was significantly greater on the GH AP view than on the conventional AP view (P < .001 for GT sclerosis, P = .003 for GT osteophyte, P = .013 for GT cyst, P < .001 for SA osteophyte, and P = .002 for humeral head osteophyte). In subgroup analysis by tear size, GT sclerosis was identified significantly more on the GH AP view for all tear sizes, GT osteophytes showed a higher detection rate, especially in medium-sized tears, and SA osteophytes showed a higher detection rate in medium and large to massive tears.
  
  
  CONCLUSIONS
  The GH view is more sensitive than the conventional AP view for detecting pathognomonic findings of rotator cuff tear. In particular, the superiority of the GH AP view in detecting abnormal radiographic findings seemed prominent in medium-sized tears.
authors: Department of Orthopaedic Surgery, Seoul Medical Center, Seoul, South Korea.
authors: Kyoung Hwan
authors: KH
authors: Koh
authors: Kye Young
authors: KY
authors: Han
authors: Young Cheol
authors: YC
authors: Yoon
authors: Seung Won
authors: SW
authors: Lee
authors: Jae Chul
authors: JC
authors: Yoo
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000473:pathology; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000000981:diagnostic imaging / Q000601:surgery; D012680:Sensitivity and Specificity; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery