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Anabolic steroids and the evaluation of patients with acute PM tendon rupture using microscopy and MRI
Alberto de Castro Pochini1, Benno Ejnisman1, Carlos V Andreoli1
1Department of Orthopaedic, Federal University of Sao Paulo, São Paulo 04022-000, Brazil.
Abstract:
This study presented a pioneering investigation of the changes in the magnetic resonance imaging images of pectoralis major muscle (PMM) tendon rupture. In all, 26 men were evaluated with acute total PMM rupture (<3 months since injury) with a mean age of 37.3 years (SD = 9.7 years) and 10 control patients with a mean age of 32.6 years (SD = 4.2 years). The evaluation of the tendon PMM injuries was based on the magnetic resonance imaging exam and the histological analysis. The magnetic resonance imaging of the surgically showed two (7.1%) contralateral sides were normal, 16 (57.1%) showed superior tendinopathy, and 10 (35.7%) had total tendinopathy. Inferior tendinopathy was not observed. The tendon histology revealed degenerative changes in 16 (66.7%) fragments, with 12 (50.0%) considered as mild (<25%), and four considered as (16.7%) high (>50.0%) tendinopathy. Total acute rupture of the PMM tendon among weightlifters might be associated with tendinous degeneration prior to injury.
Insights
Acute pectoralis major muscle (PMM) tendon rupture in weightlifters may stem from prior degeneration. MRI and histology revealed tendinopathy in most rupture cases, suggesting a link between degeneration and acute PMM tears.
Area of Science:
- Orthopedics
- Radiology
- Sports Medicine
Background:
- Pectoralis major muscle (PMM) tendon ruptures are common injuries, particularly in athletes.
- Understanding the underlying pathology of PMM tendon injuries is crucial for effective treatment and prevention.
Observation:
- This study investigated changes in magnetic resonance imaging (MRI) of the PMM tendon in patients with acute total rupture.
- 26 male patients with acute PMM rupture (<3 months) and 10 controls were evaluated using MRI and histological analysis.
- MRI revealed superior tendinopathy in 57.1% and total tendinopathy in 35.7% of ruptured PMM tendons; no inferior tendinopathy was observed.
Findings:
- Histological analysis of tendon fragments showed degenerative changes in 66.7% of cases.
- Mild tendinopathy (<25%) was present in 50.0% and high tendinopathy (>50.0%) in 16.7% of the ruptured PMM tendons.
- The findings suggest that pre-existing tendinous degeneration may be associated with acute total PMM tendon rupture in weightlifters.
Implications:
- These findings highlight the importance of assessing tendon health in athletes prone to PMM injuries.
- Early detection and management of tendinopathy could potentially prevent acute PMM tendon ruptures.
- Further research into the biomechanics and degenerative processes of the PMM tendon is warranted.
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