MRI helps guide rotator cuff tear management

MRI may be used to monitor rotator cuff changes and guide management in long-term follow-up of patients with tears who are treated nonoperatively. Factors associated with tear progression include age older than 60 years, a full-thickness tear, and fatty infiltration of the rotator cuff muscles.

Maman and associates retrospectively analyzed 59 shoulders in 54 patients. They examined MRI scans to determine whether the tear remained stable or changed (growth or shrinkage of more than 5 mm) and compared the extent of change with respect to a variety of factors.

Progression in tear size occurred more often in patients who were monitored for more than 18 months. There were 13 shoulders with tears in 12 patients (54%) in the older group and 6 shoulders in 6 patients (17%) in the younger group. Full-thickness tears were seen in 33 shoulders (56%); 12 had not undergone change, 17 increased in size, and 4 decreased. No tears that involved more than 1 tendon became smaller. An increase in tear size was more common in shoulders with fatty infiltration than in those without.

The authors noted that in the absence of clinical symptoms, the role of routine screening should be a topic of future research.