FRACTURES OF THE GREATER TUBEROSITY PRESENTING AS ROTATOR CUFF ABNORMALITY - MAGNETIC-RESONANCE DEMONSTRATION

Background: To show that magnetic resonance imaging (MRI) can be usefu l to diagnose radiographically invisible greater tuberosity fractures in patients with clinical presentations suspicious for rotator cuff in jury. Methods: Six patients with subtle greater tuberosity fractures w ho were sent for MRI because of possible rotator cuff lear are reviewe d (age range, 27-51 years; mean, 40.5 +/- 8.4 years). Five of the pati ents recount direct trauma to their shoulders, whereas one noticed sho ulder pain after a fall in which she fractured her ankle. Results: MRI shamed an area of edema confined to the greater tuberosity with linea r low signal extending through the tuberosity consistent with a fractu re in all cases. Although five patients had a complete set of shoulder radiographs before MRI, these were interpreted as normal in all cases . Full-thickness rotator cuff tears were not present in any of the cas es. All of the patients were treated conservatively with good results. Conclusions: MRI can prevent unnecessary arthroscopy in patients clin ically suspected of rotator cuff damage by showing subtle fractures of the greater tuberosity not visible on radiographs.