Abstract
The purpose of our study was to determine the incidence of cysts in and adjacent to the lesser tuberosity and their association with rotator cuff abnormalities and subcoracoid impingement. A retrospective review of 1,000 consecutive MRI examinations of the shoulder was performed by consensus of two radiologists. Cysts were grouped by location into one of two groups: those within the lesser tuberosity and those adjacent to the lesser tuberosity. The rotator cuff was defined as intact, partial tear or tendinosis, or full-thickness tear. The shortest distance from the coracoid to the humeral head was measured on axial images. Forty-eight patients (26 women, 22 men; age range, 35-79 years; mean age, 61 years) had cysts adjacent to or within the lesser tuberosity. Thirty-two patients (67%) had cysts just superior to the tuberosity and 16 (33%) had cysts in the lesser tuberosity, resulting in an incidence of 3.2% and 1.6%, respectively. All 16 patients (100%) with lesser tuberosity cysts had subscapularis and supraspinatus tendon abnormalities including 11 (69%) full-thickness supraspinatus tears. Patients with cysts superior to the tuberosity had 20 (63%, p = 0.004) abnormal subscapularis tendons and 28 (88%) abnormal supraspinatus tendons, including six (19%) full-thickness tears (p = 0.002). The coracohumeral distance was noted to be less than 10 mm in 10 patients (63%) with lesser tuberosity cysts as compared with 10 patients (31%, p = 0.06) with cysts superior to the tuberosity. Cysts located within the lesser tuberosity are rare and are indicative of subscapularis and supraspinatus tendon abnormalities.
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