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MRI of pectoralis major tears: association between ancillary findings and tear severity

Ivan R B Godoy1, Edgar L Martinez-Salazar1, F Joseph Simeone1

  • 1Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street-YAW 6048, Boston, MA, 02114, USA.

Skeletal Radiology
|February 11, 2018
PubMed
Abstract

Insights

Anterior biceps tendon (BT) displacement and peri-bicipital hematoma on MRI can indicate severe pectoralis major (PM) tears. These imaging findings correlate with full-thickness tears at the humeral insertion, aiding surgical assessment.

Area of Science:

  • Orthopedic imaging
  • Musculoskeletal radiology
  • Sports medicine

Background:

  • Pectoralis major (PM) tears can be challenging to assess for severity.
  • Magnetic Resonance Imaging (MRI) is crucial for diagnosing PM injuries.
  • Understanding imaging markers associated with tear severity is important for surgical planning.

Purpose of the Study:

  • To evaluate the diagnostic significance of anterior biceps tendon (BT) displacement and peri-bicipital hematoma on MRI in patients with PM tears.
  • To determine if these MRI findings correlate with the severity of PM tears at surgery.

Main Methods:

  • Retrospective review of MRI cases with PM injury.
  • Independent assessment of MR images by two musculoskeletal radiologists for BT displacement (BT-disp) and peri-bicipital hematoma.
  • Comparison with an age- and sex-matched control group.
  • Correlation of imaging findings with surgical reports categorized by tear severity.

Main Results:

  • Biceps tendon displacement (BT-disp) was significantly higher in PM injury patients compared to controls.
  • Higher BT-disp and the presence of peri-bicipital hematoma correlated significantly with full-thickness complete tears.
  • BT-disp > 4.5 mm demonstrated 86% sensitivity and 75% specificity for severe tears; peri-bicipital hematoma was the strongest predictor.

Conclusions:

  • Anterior biceps tendon displacement on MRI is a significant indicator in pectoralis major tears.
  • The presence of peri-bicipital hematoma is a strong predictor of full-thickness complete tears at the humeral insertion.
  • These MRI findings aid in assessing the severity of pectoralis major tears, informing surgical decisions.
Keywords:
MRIMyotendinous junctionPectoralis majorStrainTearTendon

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