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Horizontal Component of Partial-Thickness Tears of Rotator Cuff: Imaging Characteristics and Comparison of ABER View with Oblique Coronal View at MR Arthrography— Initial Results¹

¹ From the Department of Radiology, Albany Medical Center Hospital, 43 New Scotland Ave, Albany, NY 12208. Received July 23, 2001; revision requested September 11; revision received October 23; accepted December 10. Address correspondence to J.K.L. (e-mail: jlee@communitycare.com).

View larger version (120K): [in a new window]   Figure 1a. Drawings show the classification of the horizontal component of partial-thickness tears according to the appearance of the articular surface. (a) Drawing of a normal shoulder in the ABER position shows the relationship between the humerus (H), glenoid surface (G), acromion (A), rotator cuff tendon (arrows), and articular cavity (C). (b-d) Drawings of shoulders in the ABER position. White areas in the rotator cuff tendon indicate the horizontal component of a partial-thickness tear. A = acromion, C = articular cavity, G = glenoid surface, H = humerus. (b) A type A lesion appears as a horizontal or intrasubstance component in a partial-thickness tear and is associated with no abnormality of the articular surface (arrowheads). (c) A type B lesion exhibits irregularity of the articular surface (arrow). (d) A type C lesion is associated with a flap lesion (arrow) along the articular surface.

View larger version (121K): [in a new window]   Figure 1b. Drawings show the classification of the horizontal component of partial-thickness tears according to the appearance of the articular surface. (a) Drawing of a normal shoulder in the ABER position shows the relationship between the humerus (H), glenoid surface (G), acromion (A), rotator cuff tendon (arrows), and articular cavity (C). (b-d) Drawings of shoulders in the ABER position. White areas in the rotator cuff tendon indicate the horizontal component of a partial-thickness tear. A = acromion, C = articular cavity, G = glenoid surface, H = humerus. (b) A type A lesion appears as a horizontal or intrasubstance component in a partial-thickness tear and is associated with no abnormality of the articular surface (arrowheads). (c) A type B lesion exhibits irregularity of the articular surface (arrow). (d) A type C lesion is associated with a flap lesion (arrow) along the articular surface.

View larger version (121K): [in a new window]   Figure 1c. Drawings show the classification of the horizontal component of partial-thickness tears according to the appearance of the articular surface. (a) Drawing of a normal shoulder in the ABER position shows the relationship between the humerus (H), glenoid surface (G), acromion (A), rotator cuff tendon (arrows), and articular cavity (C). (b-d) Drawings of shoulders in the ABER position. White areas in the rotator cuff tendon indicate the horizontal component of a partial-thickness tear. A = acromion, C = articular cavity, G = glenoid surface, H = humerus. (b) A type A lesion appears as a horizontal or intrasubstance component in a partial-thickness tear and is associated with no abnormality of the articular surface (arrowheads). (c) A type B lesion exhibits irregularity of the articular surface (arrow). (d) A type C lesion is associated with a flap lesion (arrow) along the articular surface.

View larger version (118K): [in a new window]   Figure 1d. Drawings show the classification of the horizontal component of partial-thickness tears according to the appearance of the articular surface. (a) Drawing of a normal shoulder in the ABER position shows the relationship between the humerus (H), glenoid surface (G), acromion (A), rotator cuff tendon (arrows), and articular cavity (C). (b-d) Drawings of shoulders in the ABER position. White areas in the rotator cuff tendon indicate the horizontal component of a partial-thickness tear. A = acromion, C = articular cavity, G = glenoid surface, H = humerus. (b) A type A lesion appears as a horizontal or intrasubstance component in a partial-thickness tear and is associated with no abnormality of the articular surface (arrowheads). (c) A type B lesion exhibits irregularity of the articular surface (arrow). (d) A type C lesion is associated with a flap lesion (arrow) along the articular surface.

View larger version (147K): [in a new window]   Figure 2a. Images demonstrate a horizontal component in a partial-thickness tear that was visualized only with ABER views in a 20-year-old man. (a-c) Consecutive oblique coronal fat-suppressed T1-weighted spin-echo MR images (800/14) obtained after intraarticular injection of contrast material show the irregularity of the articular surface (solid arrows) at the insertion of the infraspinatus tendon and scalloped cortical erosions (open arrows) adjacent to the cuff lesion. (d-f) Consecutive T1-weighted spin-echo MR images (500/14) obtained with the patient in the ABER position show the grade III horizontal component (white arrowheads) of a partial tear of the infraspinatus tendon extending along the long axis of the infraspinatus tendon. The horizontal component of the tear was confirmed at surgery. Line (black arrows) between the articular cavity (C) and the area of intratendinous contrast material pooling (P) represents the articular surface of the infraspinatus tendon. On ABER views, the irregularity of the articular surface (black arrowheads) is demonstrated, indicating a type B horizontal component. An anterior labral tear (curved arrow) is also well demonstrated in d and e, and cortical bone erosions of the humeral head (open arrows) are seen in e and f.

View larger version (156K): [in a new window]   Figure 2b. Images demonstrate a horizontal component in a partial-thickness tear that was visualized only with ABER views in a 20-year-old man. (a-c) Consecutive oblique coronal fat-suppressed T1-weighted spin-echo MR images (800/14) obtained after intraarticular injection of contrast material show the irregularity of the articular surface (solid arrows) at the insertion of the infraspinatus tendon and scalloped cortical erosions (open arrows) adjacent to the cuff lesion. (d-f) Consecutive T1-weighted spin-echo MR images (500/14) obtained with the patient in the ABER position show the grade III horizontal component (white arrowheads) of a partial tear of the infraspinatus tendon extending along the long axis of the infraspinatus tendon. The horizontal component of the tear was confirmed at surgery. Line (black arrows) between the articular cavity (C) and the area of intratendinous contrast material pooling (P) represents the articular surface of the infraspinatus tendon. On ABER views, the irregularity of the articular surface (black arrowheads) is demonstrated, indicating a type B horizontal component. An anterior labral tear (curved arrow) is also well demonstrated in d and e, and cortical bone erosions of the humeral head (open arrows) are seen in e and f.

View larger version (159K): [in a new window]   Figure 2c. Images demonstrate a horizontal component in a partial-thickness tear that was visualized only with ABER views in a 20-year-old man. (a-c) Consecutive oblique coronal fat-suppressed T1-weighted spin-echo MR images (800/14) obtained after intraarticular injection of contrast material show the irregularity of the articular surface (solid arrows) at the insertion of the infraspinatus tendon and scalloped cortical erosions (open arrows) adjacent to the cuff lesion. (d-f) Consecutive T1-weighted spin-echo MR images (500/14) obtained with the patient in the ABER position show the grade III horizontal component (white arrowheads) of a partial tear of the infraspinatus tendon extending along the long axis of the infraspinatus tendon. The horizontal component of the tear was confirmed at surgery. Line (black arrows) between the articular cavity (C) and the area of intratendinous contrast material pooling (P) represents the articular surface of the infraspinatus tendon. On ABER views, the irregularity of the articular surface (black arrowheads) is demonstrated, indicating a type B horizontal component. An anterior labral tear (curved arrow) is also well demonstrated in d and e, and cortical bone erosions of the humeral head (open arrows) are seen in e and f.

View larger version (145K): [in a new window]   Figure 2d. Images demonstrate a horizontal component in a partial-thickness tear that was visualized only with ABER views in a 20-year-old man. (a-c) Consecutive oblique coronal fat-suppressed T1-weighted spin-echo MR images (800/14) obtained after intraarticular injection of contrast material show the irregularity of the articular surface (solid arrows) at the insertion of the infraspinatus tendon and scalloped cortical erosions (open arrows) adjacent to the cuff lesion. (d-f) Consecutive T1-weighted spin-echo MR images (500/14) obtained with the patient in the ABER position show the grade III horizontal component (white arrowheads) of a partial tear of the infraspinatus tendon extending along the long axis of the infraspinatus tendon. The horizontal component of the tear was confirmed at surgery. Line (black arrows) between the articular cavity (C) and the area of intratendinous contrast material pooling (P) represents the articular surface of the infraspinatus tendon. On ABER views, the irregularity of the articular surface (black arrowheads) is demonstrated, indicating a type B horizontal component. An anterior labral tear (curved arrow) is also well demonstrated in d and e, and cortical bone erosions of the humeral head (open arrows) are seen in e and f.

View larger version (140K): [in a new window]   Figure 2e. Images demonstrate a horizontal component in a partial-thickness tear that was visualized only with ABER views in a 20-year-old man. (a-c) Consecutive oblique coronal fat-suppressed T1-weighted spin-echo MR images (800/14) obtained after intraarticular injection of contrast material show the irregularity of the articular surface (solid arrows) at the insertion of the infraspinatus tendon and scalloped cortical erosions (open arrows) adjacent to the cuff lesion. (d-f) Consecutive T1-weighted spin-echo MR images (500/14) obtained with the patient in the ABER position show the grade III horizontal component (white arrowheads) of a partial tear of the infraspinatus tendon extending along the long axis of the infraspinatus tendon. The horizontal component of the tear was confirmed at surgery. Line (black arrows) between the articular cavity (C) and the area of intratendinous contrast material pooling (P) represents the articular surface of the infraspinatus tendon. On ABER views, the irregularity of the articular surface (black arrowheads) is demonstrated, indicating a type B horizontal component. An anterior labral tear (curved arrow) is also well demonstrated in d and e, and cortical bone erosions of the humeral head (open arrows) are seen in e and f.

View larger version (142K): [in a new window]   Figure 2f. Images demonstrate a horizontal component in a partial-thickness tear that was visualized only with ABER views in a 20-year-old man. (a-c) Consecutive oblique coronal fat-suppressed T1-weighted spin-echo MR images (800/14) obtained after intraarticular injection of contrast material show the irregularity of the articular surface (solid arrows) at the insertion of the infraspinatus tendon and scalloped cortical erosions (open arrows) adjacent to the cuff lesion. (d-f) Consecutive T1-weighted spin-echo MR images (500/14) obtained with the patient in the ABER position show the grade III horizontal component (white arrowheads) of a partial tear of the infraspinatus tendon extending along the long axis of the infraspinatus tendon. The horizontal component of the tear was confirmed at surgery. Line (black arrows) between the articular cavity (C) and the area of intratendinous contrast material pooling (P) represents the articular surface of the infraspinatus tendon. On ABER views, the irregularity of the articular surface (black arrowheads) is demonstrated, indicating a type B horizontal component. An anterior labral tear (curved arrow) is also well demonstrated in d and e, and cortical bone erosions of the humeral head (open arrows) are seen in e and f.

View larger version (143K): [in a new window]   Figure 3. T1-weighted spin-echo MR image (500/14) obtained in a 44-year-old man in the ABER position shows a horizontal component in a tear of the supraspinatus tendon associated with a flap lesion (solid arrows) along the articular surface. This appearance is characteristic of a type C horizontal component. The horizontal component of the partial-thickness tear communicates with the articular cavity through the flap tear. A detached anterior labrum (open arrow) is also depicted. Most flap lesions were clearly demonstrated only on ABER views rather than on oblique coronal MR images.

View larger version (103K): [in a new window]   Figure 4. Fat-suppressed oblique transverse T1-weighted MR image (550/10) obtained in a 31-year-old man after intraarticular injection of contrast material and with the patient in the ABER position shows a type B horizontal component in a tear of the supraspinatus tendon, with irregularity of the articular surface (arrowheads) adjacent to the head of the humerus.

View larger version (172K): [in a new window]   Figure 5. T1-weighted spin-echo MR image (500/14) obtained in a 34-year-old man with the patient in the ABER position shows the horizontal component in a tear of the infraspinatus tendon but reveals no abnormality of the articular surface, indicating a type A horizontal component. The horizontal component of the tear of the infraspinatus tendon (H) extends from the cortex of the humeral head along the long axis of the infraspinatus tendon; the articular surface (arrowheads) of the tendon is intact. The vertical thickness of the horizontal component was grade II.