title: Dynamic Three-Dimensional Shoulder Mri during Active Motion for Investigation of Rotator Cuff Diseases.
abstract: BACKGROUND
  MRI is the standard methodology in diagnosis of rotator cuff diseases. However, many patients continue to have pain despite treatment, and MRI of a static unloaded shoulder seems insufficient for best diagnosis and treatment. This study evaluated if Dynamic MRI provides novel kinematic data that can be used to improve the understanding, diagnosis and best treatment of rotator cuff diseases.
  
  
  METHODS
  Dynamic MRI provided real-time 3D image series and was used to measure changes in the width of subacromial space, superior-inferior translation and anterior-posterior translation of the humeral head relative to the glenoid during active abduction. These measures were investigated for consistency with the rotator cuff diseases classifications from standard MRI.
  
  
  RESULTS
  The study included: 4 shoulders with massive rotator cuff tears, 5 shoulders with an isolated full-thickness supraspinatus tear, 5 shoulders with tendinopathy and 6 normal shoulders. A change in the width of subacromial space greater than 4mm differentiated between rotator cuff diseases with tendon tears (massive cuff tears and supraspinatus tear) and without tears (tendinopathy) (p = 0.012). The range of the superior-inferior translation was higher in the massive cuff tears group (6.4mm) than in normals (3.4mm) (p = 0.02). The range of the anterior-posterior translation was higher in the massive cuff tears (9.2 mm) and supraspinatus tear (9.3 mm) shoulders compared to normals (3.5mm) and tendinopathy (4.8mm) shoulders (p = 0.05).
  
  
  CONCLUSIONS
  The Dynamic MRI enabled a novel measure; 'Looseness', i.e. the translation of the humeral head on the glenoid during an abduction cycle. Looseness was better able at differentiating different forms of rotator cuff disease than a simple static measure of relative glenohumeral position.
authors.affiliation: Laboratory of Biomechanics, Arts et métiers ParisTech, Paris, France.|Upper Limb Surgery, European Hospital Georges Pompidou, APHP, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Tempelaere
authors.affiliation: Laboratory of Biomechanics, Arts et métiers ParisTech, Paris, France.|Upper Limb Surgery, European Hospital Georges Pompidou, APHP, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors.forename: Jérome
authors.initials: J
authors.lastname: Pierrart
authors.affiliation: Physical Medicine and Rehabilitation Unit, Cochin Hospital, APHP, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors.forename: Marie-Martine
authors.initials: MM
authors.lastname: Lefèvre-Colau
authors.affiliation: Radiology Unit, European Hospital Georges Pompidou, APHP, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Vuillemin
authors.affiliation: Radiology Unit, European Hospital Georges Pompidou, APHP, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors.forename: Charles-André
authors.initials: CA
authors.lastname: Cuénod
authors.affiliation: Department of Mechanical Engineering, Imperial College London, London, United Kingdom.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hansen
authors.affiliation: Institut MOVEO, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Mir
authors.affiliation: Laboratory of Biomechanics, Arts et métiers ParisTech, Paris, France.
authors.forename: Wafa
authors.initials: W
authors.lastname: Skalli
authors.affiliation: Upper Limb Surgery, European Hospital Georges Pompidou, APHP, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.|Department of Mechanical Engineering, Imperial College London, London, United Kingdom.|Institut MOVEO, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gregory
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D058430:Humeral Head / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009068:Movement; D011446:Prospective Studies; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D012540:Scapula / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D052256:Tendinopathy / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology