Novel Anatomic Concepts in Magnetic Resonance Imaging of the Rotator Cuff Tendons and the Footprint

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Footprint of the supraspinatus, infraspinatus, and teres minor tendons

Understanding the osseous anatomy of the humeral head is an important requisite for describing the rotator cuff tendon insertions. The classic anatomy of the greater tuberosity of the proximal humerus describes 3 impressions or facets, which have often been designated as superior, middle, and inferior facets or, alternatively, as horizontal, oblique, and vertical facets (Fig. 1). As in previous anatomic studies and traditional descriptions, these facets receive the insertional fibers of the

Footprint of the subscapularis tendon

Although a great deal of literature on the investigation of the superior cuff has been published, the anatomy of the subscapularis tendon footprint has garnered only recent attention. The subscapularis tendon may be injured because of falls on an outstretched arm, anterior glenohumeral joint dislocations, or subcoracoid impingement.30 Tears of the subscapularis tendon were once thought to be uncommon, comprising 3.5% to 8% of rotator cuff tendon tears; however, with the advancement of

Summary

Knowledge of the precise anatomic characteristics of the footprints of the rotator cuff tendons continues to evolve. These anatomic characteristics are fundamental to the understanding of the pathogenesis of cuff failure, clinical manifestations of such failure, and development of the optimal treatment protocols. Regarding the greater tuberosity, recent literature suggests that the infraspinatus tendon may occupy a more substantial portion of the anterior facet than previously thought and may

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Cited by (8)

  • Postoperative MR Imaging of the Rotator Cuff

    2022, Magnetic Resonance Imaging Clinics of North America
    Citation Excerpt :

    The teres minor muscle originates from the lower portion of the infraspinous fossa on the posterior aspect of the scapula and its tendon inserts into the inferior facet of the greater tuberosity. Contrary to popular belief, the supraspinatus footprint is smaller in size, more anteriorly placed, and shared with the infraspinatus, whereas the infraspinatus footprint is substantially bigger than previously assumed.9 The force couples of the shoulder are a crucial concept to understand the pathoanatomy of superior humeral migration which occurs with rotator cuff pathology.

  • Volumetric evaluation of the rotator cuff musculature in massive rotator cuff tears with pseudoparalysis

    2017, Journal of Shoulder and Elbow Surgery
    Citation Excerpt :

    Furthermore, many studies on the footprint anatomy of rotator cuffs have elucidated the complexity of the SS and IS insertion to the tuberosities. They are attached to the greater tuberosity and sometimes even to the lesser tuberosity in the form of 1 inseparable unit, not as 2 separate tendons to each relevant facet of greater tuberosity.14,22 For these reasons, in the present study, we analyzed the muscle volume to quantify forces acting on the shoulder joint.

  • Clinical Anatomy of the Elbow and Shoulder

    2012, Reumatologia Clinica
    Citation Excerpt :

    The rotator cuff muscles are teres minor, infraspinatus, supraspinatus and subscapularis (Fig. 13a and b). These muscles originate in the scapula and prior to their insertion in the humeral tubercles their tendons splay out in a continuous, interdigitated cap known as the rotator cuff.38,51 Taken in isolation the first two muscles cause external rotation, the third, abduction and the fourth, internal rotation.

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The authors have nothing to disclose.

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