Purpose

To evaluate the diagnostic efficacy of indirect signs for proximal articular-positioned, partial (< 50%), subscapularis tendon tears (facet 1 tears) via conventional magnetic resonance imaging (MRI).

Methods

A retrospective study was conducted on 67 patients of Yoo’s type 1 or 2A tears. Forty-five arthroscopic subacromial decompression and acromioclavicular resection cases served as controls. Indirect signs indicating a facet 1 tear included small defects, superior subscapularis recess (SSR), long head of the biceps (LHBT) configurations, bone edema or cyst formation on lesser tuberosity (LTBEC), and fatty infiltration of subscapularis muscle. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were checked.

Results

SSR was the most sensitive sign (90%). The sensitivities and NPV of LHBT configurations and LTBEC were low (sensitivity: 42.9% and 17.9%, NPV: 56.4% and 44.4%, respectively). The specificities of all indirect signs were relatively high (> 90%). The Chi-squared test and multinomial logistic regression confirmed the significance of small defects, SSRs, and fatty infiltrations for facet 1 tears (p ≤ 0.014). The combined sensitivity and specificity were up to 97.7% and 92.3%, respectively, in the presence of either a small defect or an SSR.

Conclusions

Conventional MRI alone can detect facet 1 tears through indirect signs (small defects, SSR, and fatty infiltrations of the subscapularis muscle), predicting unspecified anterior shoulder pain due to concealed biceps instability, and facilitating preoperative diagnosis for a facet 1 tear.

Level of evidence

III.

中文翻译：

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通过常规磁共振成像检测局部肩s下肌腱撕裂的间接体征来预测前肩痛源。

目的

若要通过常规磁共振成像（MRI）评估间接体征对近端关节定位的局部（<50％），肩s下肌腱撕裂（小平面1撕裂）的诊断功效。

方法

对67例Yoo的1型或2A型眼泪患者进行了回顾性研究。45例关节镜下肩峰下减压和肩锁骨切除术病例作为对照。刻面1撕裂的间接迹象包括小缺陷，肩s下隐窝（SSR），二头肌长头（LHBT）构型，较小结节处的骨水肿或囊肿（LTBEC）以及肩，下肌脂肪浸润。检查敏感性，特异性，阳性预测值（PPV），阴性预测值（NPV）和准确性。

结果

SSR是最敏感的体征（90％）。LHBT构型和LTBEC的灵敏度和NPV较低（灵敏度分别为42.9％和17.9％，NPV：56.4％和44.4％）。所有间接体征的特异性都较高（> 90％）。卡方检验和多项Logistic回归证实的小缺陷，固态继电器，和脂肪浸润的刻面的眼泪意义（p  ≤0.014）。在存在小缺陷或SSR的情况下，组合的敏感性和特异性分别高达97.7％和92.3％。

结论

仅常规MRI就能通过间接体征（小缺陷，SSR和肩cap下肌脂肪浸润）检测小平面1撕裂，预测由于隐藏的二头肌不稳定性而导致的未明确的前肩痛，并有助于术前对小平面1撕裂的诊断。

证据水平

三，