Incomplete Thickness Rotator Cuff Tears Diagnosed by Subacromial Bursography

Abstract

Incomplete thickness rotator cuff tears (ITRCT) adjacent to the bursal sac were diagnosed preoperatively by subacromial bursography and confirmed by surgical exposure. There were five men and one woman with an average age of 41.8 years. The preoperative duration of shoulder pain ranged from four to 36 months (average, 15.8 months). Clinical manifestations included crepitus and a painful arc in five of the six cases. Glenohumeral arthrography was normal in all cases. Subacromial bursography, subsequently performed, revealed pooling of the contrast medium in a torn area of the bursal side of the rotator cuff in all cases. Surgical treatment was recommended after the failure of conservative treatment for three to ten months. The surgical treatment consisted of both anterior acromioplasty and tendon suture. Wedge resection and shoelace suture repair of the tendon produced satisfactory results in all cases followed for ten to 72 months (average, 44.3 months). ITRCT adherent to the bursal sac were noted in 2.4% of a cadaver survey. Subacromial bursography can be a useful diagnostic procedure for this specific entity in subacromial impingement syndrome.