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Rotator Cuff Tendinopathy
Michael J. Tuite, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          TERMINOLOGY

          • Synonyms

            • Tendinosis, tendinitis, rotator cuff impingement syndrome, painful shoulder syndrome
              • Tendinitis is not preferred term because there are no inflammatory cells
          • Definitions

            • Collagenous degeneration of rotator cuff tendons, usually supraspinatus (SS) tendon

          IMAGING

          • General Features

            • Radiographic Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Gellhorn AC et al: Intense focused ultrasound stimulation of the rotator cuff: evaluation of the source of pain in rotator cuff tears and tendinopathy. Ultrasound Med Biol. 41(9):2412-9, 2015
                                        2. McCreesh KM et al: Acromiohumeral distance measurement in rotator cuff tendinopathy: is there a reliable, clinically applicable method? A systematic review. Br J Sports Med. 49(5):298-305, 2015
                                        3. Arend CF et al: Diagnostic value of tendon thickness and structure in the sonographic diagnosis of supraspinatus tendinopathy: room for a two-step approach. Eur J Radiol. 83(6):975-9, 2014
                                        4. McCreesh KM et al: Acromiohumeral distance measurement in rotator cuff tendinopathy: is there a reliable, clinically applicable method? A systematic review. Br J Sports Med. ePub, 2013
                                        5. Lewis JS: Rotator cuff tendinopathy/subacromial impingement syndrome: is it time for a new method of assessment? Br J Sports Med. 43(4):259-64, 2009
                                        6. Mayerhoefer ME et al: Shoulder impingement: relationship of clinical symptoms and imaging criteria. Clin J Sport Med. 19(2):83-9, 2009
                                        7. Teefey SA et al: Shoulder ultrasound vs MRI for rotator cuff pathology. PM R. 1(5):490-5, 2009
                                        8. Fritz LB et al: Cystic changes at supraspinatus and infraspinatus tendon insertion sites: association with age and rotator cuff disorders in 238 patients. Radiology. 244(1):239-48, 2007
                                        9. Hambly N et al: Rotator cuff impingement: correlation between findings on MRI and outcome after fluoroscopically guided subacromial bursography and steroid injection. AJR Am J Roentgenol. 189(5):1179-84, 2007
                                        10. Sein ML et al: Reliability of MRI assessment of supraspinatus tendinopathy. Br J Sports Med. 41(8):e9, 2007
                                        11. Vanhoenacker FM et al: MR arthrography of the rotator cuff. JBR-BTR. 90(5):338-44, 2007
                                        12. Uri DS: MR imaging of shoulder impingement and rotator cuff disease. Radiol Clin North Am. 35(1):77-96, 1997
                                        13. Williams GR Jr et al: Anatomic, histologic, and magnetic resonance imaging abnormalities of the shoulder. Clin Orthop Relat Res. (330):66-74, 1996
                                        14. Timins ME et al: Increased signal in the normal supraspinatus tendon on MR imaging: diagnostic pitfall caused by the magic-angle effect. AJR Am J Roentgenol. 165(1):109-14, 1995
                                        15. Riley GP et al: Tendon degeneration and chronic shoulder pain: changes in the collagen composition of the human rotator cuff tendons in rotator cuff tendinitis. Ann Rheum Dis. 53(6):359-66, 1994
                                        16. Vahlensieck M et al: Two portions of the supraspinatus muscle: a new finding about the muscles macroscopy by dissection and magnetic resonance imaging. Surg Radiol Anat. 16(1):101-4, 1994
                                        17. Vahlensieck M et al: Two segments of the supraspinous muscle: cause of high signal intensity at MR imaging? Radiology. 186(2):449-54, 1993
                                        18. Fu FH et al: Shoulder impingement syndrome. A critical review. Clin Orthop Relat Res. (269):162-73, 1991
                                        19. Kjellin I et al: Alterations in the supraspinatus tendon at MR imaging: correlation with histopathologic findings in cadavers. Radiology. 181(3):837-41, 1991
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Tendinosis, tendinitis, rotator cuff impingement syndrome, painful shoulder syndrome
                                                    • Tendinitis is not preferred term because there are no inflammatory cells
                                                • Definitions

                                                  • Collagenous degeneration of rotator cuff tendons, usually supraspinatus (SS) tendon

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • MR Findings

                                                      • Ultrasonographic Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Gellhorn AC et al: Intense focused ultrasound stimulation of the rotator cuff: evaluation of the source of pain in rotator cuff tears and tendinopathy. Ultrasound Med Biol. 41(9):2412-9, 2015
                                                                              2. McCreesh KM et al: Acromiohumeral distance measurement in rotator cuff tendinopathy: is there a reliable, clinically applicable method? A systematic review. Br J Sports Med. 49(5):298-305, 2015
                                                                              3. Arend CF et al: Diagnostic value of tendon thickness and structure in the sonographic diagnosis of supraspinatus tendinopathy: room for a two-step approach. Eur J Radiol. 83(6):975-9, 2014
                                                                              4. McCreesh KM et al: Acromiohumeral distance measurement in rotator cuff tendinopathy: is there a reliable, clinically applicable method? A systematic review. Br J Sports Med. ePub, 2013
                                                                              5. Lewis JS: Rotator cuff tendinopathy/subacromial impingement syndrome: is it time for a new method of assessment? Br J Sports Med. 43(4):259-64, 2009
                                                                              6. Mayerhoefer ME et al: Shoulder impingement: relationship of clinical symptoms and imaging criteria. Clin J Sport Med. 19(2):83-9, 2009
                                                                              7. Teefey SA et al: Shoulder ultrasound vs MRI for rotator cuff pathology. PM R. 1(5):490-5, 2009
                                                                              8. Fritz LB et al: Cystic changes at supraspinatus and infraspinatus tendon insertion sites: association with age and rotator cuff disorders in 238 patients. Radiology. 244(1):239-48, 2007
                                                                              9. Hambly N et al: Rotator cuff impingement: correlation between findings on MRI and outcome after fluoroscopically guided subacromial bursography and steroid injection. AJR Am J Roentgenol. 189(5):1179-84, 2007
                                                                              10. Sein ML et al: Reliability of MRI assessment of supraspinatus tendinopathy. Br J Sports Med. 41(8):e9, 2007
                                                                              11. Vanhoenacker FM et al: MR arthrography of the rotator cuff. JBR-BTR. 90(5):338-44, 2007
                                                                              12. Uri DS: MR imaging of shoulder impingement and rotator cuff disease. Radiol Clin North Am. 35(1):77-96, 1997
                                                                              13. Williams GR Jr et al: Anatomic, histologic, and magnetic resonance imaging abnormalities of the shoulder. Clin Orthop Relat Res. (330):66-74, 1996
                                                                              14. Timins ME et al: Increased signal in the normal supraspinatus tendon on MR imaging: diagnostic pitfall caused by the magic-angle effect. AJR Am J Roentgenol. 165(1):109-14, 1995
                                                                              15. Riley GP et al: Tendon degeneration and chronic shoulder pain: changes in the collagen composition of the human rotator cuff tendons in rotator cuff tendinitis. Ann Rheum Dis. 53(6):359-66, 1994
                                                                              16. Vahlensieck M et al: Two portions of the supraspinatus muscle: a new finding about the muscles macroscopy by dissection and magnetic resonance imaging. Surg Radiol Anat. 16(1):101-4, 1994
                                                                              17. Vahlensieck M et al: Two segments of the supraspinous muscle: cause of high signal intensity at MR imaging? Radiology. 186(2):449-54, 1993
                                                                              18. Fu FH et al: Shoulder impingement syndrome. A critical review. Clin Orthop Relat Res. (269):162-73, 1991
                                                                              19. Kjellin I et al: Alterations in the supraspinatus tendon at MR imaging: correlation with histopathologic findings in cadavers. Radiology. 181(3):837-41, 1991