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High diagnostic accuracy of magnetic resonance imaging in detecting subscapularis tendon tears by focusing on the most superior portion of the subscapularis tendon

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Abstract

Purpose

This study aimed to test the hypothesis that identifying the exact location of the most superior portion of the subscapularis tendon using magnetic resonance imaging (MRI) provides high diagnostic accuracy in detecting subscapularis tendon tears.

Methods

This study included 157 patients who underwent primary arthroscopic rotator cuff repair between 2014 and 2017. All patients underwent conventional 1.5-T MRI in our hospital, within 3 months before surgery. We retrospectively compared the diagnosis of subscapularis tendon tears using MRI based on an anatomical concept focusing on the superior-most insertion point of the subscapularis tendon with intraoperative arthroscopic findings.

Results

Subscapularis tendon tears were detected in 80 (51.0%) of the 157 patients during arthroscopic evaluation. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the MRI examination were 90, 83, 85, 89, and 87%, respectively. With a kappa score of 0.83, the concordance rate between the two raters was almost perfect (95% confidence interval, 0.75–0.92). The sensitivities of the oblique-sagittal and axial sequences were 84 and 79%, respectively.

Conclusions

Preoperative MRI evaluation focusing on the most superior portion of the subscapularis tendon demonstrated high diagnostic accuracy in detecting subscapularis tendon tears. To find the most superior portion of the subscapularis tendon tears, it was essential to check the slice at the level of the lesser tubercle tip and its adjacent slice. In addition, the combined observation of oblique-sagittal and axial sequences helped to detect subscapularis tendon tears with higher sensitivity.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Satoshi Takagi for his help in the initial preparation of data.

Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kawaguchi Kogyo General Hospital, 1-18-15 Aoki, Kawaguchi-shi, Saitama, 332-0031, Japan

    Shoichi Hasegawa & Hideya Yoshimura

  2. Department of Orthopaedic Surgery, Tokyo-Kita Medical Centre, 4-17-56 Akabanedai, Kita-ku, Tokyo, 115-0053, Japan

    Tomoyuki Mochizuki

  3. Department of Orthopaedic Surgery, Kyoto Katsura Hospital, 17 Yamadahirao-cho, Nishikyo-ku, Kyoto, 615-8256, Japan

    Ryuzo Arai

  4. Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Keiichi Akita

  5. Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Akimoto Nimura

Authors
  1. Shoichi Hasegawa
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  2. Hideya Yoshimura
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  3. Tomoyuki Mochizuki
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  4. Ryuzo Arai
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  5. Keiichi Akita
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  6. Akimoto Nimura
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Contributions

SH: data extraction and analysis, and manuscript drafting. HY: Project planning, management of data analysis, and manuscript review. TM: manuscript review and editing. RA: Project planning and manuscript review. KA: Statistical analysis and manuscript review. AN: Management of data analysis, manuscript editing and review.

Corresponding author

Correspondence to Hideya Yoshimura.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

Ethical approval for this study was granted following review by the Kawaguchi Kogyo General Hospital Institutional Review Board (#105321).

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Informed consent was obtained from all individual participants included in the study.

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Informed consent regarding publishing their data and photographs was obtained from all individual participants included in the study.

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Hasegawa, S., Yoshimura, H., Mochizuki, T. et al. High diagnostic accuracy of magnetic resonance imaging in detecting subscapularis tendon tears by focusing on the most superior portion of the subscapularis tendon. Surg Radiol Anat 45, 17–24 (2023). https://doi.org/10.1007/s00276-022-03059-7

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  • DOI: https://doi.org/10.1007/s00276-022-03059-7

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