title: Age, trauma and the critical shoulder angle accurately predict supraspinatus tendon tears.
abstract: BACKGROUND
  The pathogenesis of full-thickness tears of the rotator cuff remains unclear. Apart from age and trauma, distinct scapular morphologies have been found to be associated with rotator cuff disease. The purpose of the present study was to evaluate whether a score formed using these established risk factors was able to predict the presence of a rotator cuff tear reliably.
  
  
  METHODS
  We retrospectively assessed a consecutive series of patients with a minimal age of 40 years old, who had true antero-posterior (AP) radiographs of their shoulders, as well as a magnetic resonance (MR) gadolinium-arthrography, between January and December 2011. In all of these patients, the critical shoulder angle (CSA) was determined, and MR images were assessed for the presence of rotator cuff tears. Additionally, the patients' charts were reviewed to obtain details of symptom onset. Based on these factors, the so-called rotator cuff tear (RCT) score was calculated.
  
  
  RESULTS
  Patients with full-thickness RCTs were significantly older and had significantly larger CSAs than patients with intact rotator cuffs. Multiple logistic regression, using trauma, age and CSA as independent variables, revealed areas under the curve (AUCs) for trauma of 0.55, for age of 0.65 and for CSA of 0.86. The combination of all three factors was the most powerful predictor, with an AUC of 0.92.
  
  
  CONCLUSIONS
  Age, trauma and the CSA can accurately predict the presence of a posterosuperior RCT.
  
  
  METHODS
  Level IV. Case series with no comparison groups.
authors.affiliation: Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland; Department of Orthopaedic Surgery and Traumatology, University of Berne, Insel Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland. Electronic address: beat.moor@insel.ch.
authors.forename: B K
authors.initials: BK
authors.lastname: Moor
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, University of Berne, Insel Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Röthlisberger
authors.affiliation: Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.
authors.forename: D A
authors.initials: DA
authors.lastname: Müller
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, University of Berne, Insel Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland.
authors.forename: M A
authors.initials: MA
authors.lastname: Zumstein
authors.affiliation: Division of Trauma Surgery, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Bouaicha
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hautepierre Hospital, University of Strasbourg, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Ehlinger
authors.affiliation: Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Gerber
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001175:Arthrography; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000473:pathology; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000473:pathology*; D013708:Tendon Injuries / Q000145:classification / Q000175:diagnosis*
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: Age-related rotator cuff tear; Critical shoulder angle; Pathogenesis; Rotator cuff; Scapular morphology; Trauma