title: Symptomatic rotator cuff tears show higher radioisotope uptake on bone scintigraphy compared with asymptomatic tears.
abstract: BACKGROUND
  Some patients with rotator cuff tears complain of pain, whereas others are asymptomatic. Previous studies have pointed out the presence of active bone metabolism in the painful shoulder, identified with increased radioisotope uptake during bone scintigraphy.
  
  
  OBJECTIVE
  Shoulders with symptomatic rotator cuff tears will demonstrate higher radioisotope uptake than shoulders with asymptomatic tears with bone scintigraphy, reflecting active bone metabolism in symptomatic tears.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 3.
  
  
  METHODS
  The study consisted of 3 groups: patients with symptomatic tears (symptomatic group), patients with asymptomatic tears (asymptomatic group), and controls (no tear group). The symptomatic group consisted of 28 shoulders from 28 patients with symptomatic rotator cuff tears (pain score ≤4 on the University of California, Los Angeles [UCLA] shoulder evaluation form) who underwent bone scintigraphy followed by rotator cuff repair. Of 70 volunteers who had previously undergone bone scintigraphy for diseases unrelated to their shoulder, 34 were selected for the asymptomatic group (pain score ≥8 on the UCLA shoulder form), and 32 were selected for the no tear group.
  
  
  RESULTS
  The mean radioisotope uptake in the symptomatic group was significantly higher than that in the asymptomatic group (P = .02) and the no tear group (P = .02). Ten of 28 shoulders (36%) in the symptomatic group showed increased radioisotope uptake exceeding 2 standard deviations from the mean of the no tear group. This percentage was significantly higher when compared with the asymptomatic group (0%) (P < .01).
  
  
  CONCLUSIONS
  Shoulders with a symptomatic rotator cuff tear showed higher radioisotope uptake on bone scintigraphy than those with an asymptomatic tear. The radioisotope uptake in shoulders with an asymptomatic tear was comparable with that in shoulders without a tear.
  
  
  CONCLUSIONS
  Positive radioisotope uptake may be associated with pain in a subgroup of patients with rotator cuff tears.
authors.affiliation: Department of Orthopaedic Surgery, Japanese Red Cross Sendai Hospital, 2-43-3 Yagiyama-honcho, Taihaku-ku, Sendai, Miyagi 982-8501, Japan. yokoike@gmail.com
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Koike
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sano
authors.forename: Atushi
authors.initials: A
authors.lastname: Kita
authors.forename: Eiji
authors.initials: E
authors.lastname: Itoi
mesh_terms: D000368:Aged; D001134:Arm Injuries / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D017006:Rotator Cuff / Q000000981:diagnostic imaging; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000378:metabolism; D020069:Shoulder Pain / Q000000981:diagnostic imaging*
chemical_list: D015609:Organotechnetium Compounds
keywords: bone metabolism; bone scintigraphy; cause; rotator cuff tear