Rotator Cuff Tears: Should Abduction and External Rotation (ABER) Positioning Be Performed Before Image Acquisition? A CT Arthrography Study

Overview

Journal Eur Radiol

Specialty Radiology

Date 2009 Nov 6

PMID 19890647

Citations 3

Authors

Hubert Cochet

Stephane Couderc

Eric Pele

Nicolas Amoretti

Marie-Helene Moreau-Durieux

Olivier Hauger

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the impact of abduction and external rotation (ABER) positioning performed before image acquisition on the assessment of rotator cuff tears.

Methods: Twenty-seven consecutive patients with clinically suspected rotator cuff tears underwent an initial CT arthrogram of the shoulder in neutral position, immediately followed by temporary ABER positioning, before a second CT acquisition in neutral position. Two observers blinded to potential pre-procedure ABER positioning independently analysed the randomly distributed images. Lesions were classified into partial-thickness (PT) and full-thickness (FT) tear subtypes. Lesion detection and measurements of pre- and post-ABER studies were compared.

Results: We found no influence of pre-test ABER positioning on FT detection or measurements. Every PT detected on pre-ABER study was also detected on post-ABER study (28/28 for reader 1, and 32/32 for reader 2). Seven and eight additional PT were found by readers 1 and 2, respectively, on post-ABER study. Lesion size increased after ABER in terms of area (P < 0.001 for both readers) and Ellman's grade (P = 0.02 and 0.002 for reader 1 and 2, respectively).

Conclusion: ABER positioning before CT is associated with improved delineation of partial tears, a higher number of detected tears and modification of treatment planning.

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