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Association between Hypertrophic Change of Greater Tuberosity in Plain Radiography and Rotator Cuff Tears
Ji Weon Mun1, Sang Yun Oh2, Seung Won Hyun1
1Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Clinics in Orthopedic Surgery
|October 20, 2025
Summary
Greater tuberosity (GT) spurs on X-rays predict rotator cuff tears (RCTs), even with negative physical exams. These spurs correlate with more severe tears, indicating the need for advanced imaging in patients with shoulder pain.
Area of Science:
- Orthopedic Surgery
- Radiology
- Sports Medicine
Background:
- Greater tuberosity (GT) spurs are bony outgrowths that may be associated with shoulder pathology.
- The diagnostic utility of GT spurs in predicting rotator cuff tears (RCTs) requires further investigation.
- Comparing magnetic resonance imaging (MRI) and simple radiography can elucidate the implications of GT spurs.
Purpose of the Study:
- To evaluate the diagnostic implications of greater tuberosity (GT) spurs in predicting rotator cuff tears (RCTs).
- To compare the effectiveness of plain radiography and physical examinations in identifying RCTs.
- To determine if plain radiography can reliably indicate the need for advanced imaging studies like MRI.
Main Methods:
- A retrospective cohort study comparing 94 patients with GT spurs to 91 controls without spurs.
- Patients underwent physical examinations (Jobe's test, external rotation power) and imaging (plain radiography, MRI).
- MRI findings were analyzed to assess tear severity (partial vs. full-thickness, bursal side tears) in relation to GT spurs.
Main Results:
- While physical exams were less sensitive in the GT spur group, MRI revealed more severe RCTs (high-grade partial to full-thickness) in patients with spurs.
- The GT spur group showed a higher ratio of full-thickness tears and a greater proportion of bursal-side partial tears.
- Plain radiography identified GT spurs, which were predictive of supraspinatus tendon tears.
Conclusions:
- Greater tuberosity (GT) spurs detected on plain radiographs are significant predictors of rotator cuff tears (RCTs), particularly supraspinatus tears.
- Even with negative physical examination findings, the presence of GT spurs warrants further investigation with advanced imaging.
- Radiographic detection of GT spurs aids in identifying patients who may benefit from MRI for rotator cuff pathology evaluation.
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