Contrast-enhanced MRI of the subdeltoid, subacromial bursa in painful and painless rotator cuff tears

R. J. Hodgson, P. J. O'Connor, E. M A Hensor, D. Barron, P. Robinson

    Research output: Contribution to journalArticlepeer-review


    Objective: Although shoulder pain is often associated with rotator cuff tears, many tears are asymptomatic and are not the cause of the patient's pain. This may explain the persistence of symptoms in some patients despite technically successful rotator cuff repair. It has been proposed that rotator cuff tears cause pain through subdeltoid/subacromial bursal inflammation. The aim of this study was to determine whether bursal inflammation seen on MRI is associated with pain in patients with rotator cuff tears of the shoulder. Methods: The shoulders of 255 patients were screened with ultrasound. 33 fullthickness rotator cuff tears (18 with shoulder pain and 15 without pain) were identified and subsequently studied using contrast-enhanced MRI of the shoulder. Enhancement of the subacromial bursa was scored independently by two musculoskeletal radiologists. Logistic regression was used to determine whether bursal enhancement was independently associated with pain. Results: There was a significant association between pain and age, with greater likelihood of pain in younger patients. Bursal enhancement was common in both painful and painless tears. No statistically significant link between pain and bursal enhancement was seen, even after accounting for age. Conclusion: Although enhancement of the subdeltoid/subacromial bursa was common, no evidence was found to support the hypothesis that bursal enhancement is associated with pain in rotator cuff tears. It is therefore unlikely to determine reliably which patients would benefit from rotator cuff repair. Advances in knowledge: Bursal enhancement and thickening does not reliably correlate with symptoms or presence of rotator cuff tear. © 2012 The British Institute of Radiology.
    Original languageEnglish
    Pages (from-to)1482-1487
    Number of pages5
    JournalBritish Journal of Radiology
    Issue number1019
    Publication statusPublished - Nov 2012


    • Female
    • Humans
    • *Magnetic Resonance Imaging/methods
    • Male
    • Rotator Cuff/*injuries/pathology/ultrasonography
    • Shoulder Joint/pathology/ultrasonography
    • Shoulder Pain/*diagnosis/etiology/pathology/ultrasonography


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