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[Radiological exploration of the shoulder rotator cuff]
1Service de Radiologie, Hôpital Saint-Antoine, Paris.
Abstract:
Plain X-rays and Lecler's manoeuvre constitute the essential basic assessment in the diagnostic approach to lesions of the rotator cuff. The preoperative assessment of the lesions and the search for associated lesions are based on more or less invasive investigations. For many years, arthrography was the reference examination to establish a precise assessment, but was sometimes insufficient for the diagnosis of small partial non-communicating lesions and certain longstanding massive ruptures. Ultrasonography is an attractive non-invasive technique, but the quality of the results depends on the operator's experience. Although computed tomography and CT arthrography provide a perfect analysis of the anterior aspect of the cuff and evaluate the trophicity of the muscles, they are difficult to interpret, irradiating and sometimes incomplete. MRI, a non-invasive and non-irradiating technique, is the modality of choice due to its excellent contrast resolution and the possibility of multidirectional studies and a spatial resolution which is continually improved by new acquisition sequences and the use of better adapted surface coils.