Roentgenographic assessment of the rotator cuff

In assessment of the rotator cuff, roentgenograms are mandatory. They permit judgment of the degree and site of bony involvement, assessment of the relationship between humeral head and glenoid, and differential diagnosis. Single-contrast arthrography is used to confirm the presence or the absence of a tear in the rotator cuff, particularly when a small tear is suspected. If the tear is large or if active lateral rotation is absent, tomoarthrography using air should be performed in the frontal and sagittal planes. If an anteromedial dislocation of the long head of the biceps or a tear of the subcapularis is suspected, computed tomoarthrography (CTA) is indicated. CTA shows the major part of the anterior cuff tendons. Computed tomography (CT) densitometry of the rotator cuff muscles, performed routinely before and after surgery, permits an objective evaluation of their functional status.