Strict anteroposterior straight-beam decubitus view of the shoulder: valuein the assessment of rotator cuff tears

Purpose. To compare the contribution of various radiographic projections in the evaluation of impingement syndrome and rotator cuff tears. Materials and method. We realized a prospective study in 53 patients with s uspected rotator cuff tear, evaluated by plain radiographs and arthrography (gold standard). 31 patients were men and 22 were women (mean age 51 years ). In all patients, anteroposterior radiograph, strict anteroposterior stra ight-beam decubitus view and anteroposterior radiograph during Leclercq's m aneuver of the affected shoulder were obtained. The population was divided into three groups: group 1: normal arthrography (n=19), group 2: isolated s upraspinatus tendon tear (n=23), group 3: rupture of the supraspinatus and infraspinatus tendons (n=11). The acromio-humeral space was measured on all these views and differences between the three groups were statistically an alyzed. Results. There is a significant statistical difference between the height o f the acromio-humeral space found in patients with isolated tear of the sup raspinatus tendon and those with a tear extending to the infraspinatus tend on (p=0.0001). The ROC methodology showed a better accuracy of the strict a nteroposterior straight-beam decubitus view in cases of wide ruptures of th e rotator cuff, and this for a selected threshold value of 6 mm. Conclusion. Strict anteroposterior straight-beam decubitus view, seems to b e easy to realize, cheap, reproducible and very powerful in the preoperativ e assessment of patients with suspected rotator cuff tendon tear. It allows an excellent visualization of the acromioclavicular joint.