MR imaging evaluation of cystic changes in the humeral head

Objective: We aimed to assess the association between rotator cuff tendon disorders and the presence of cystic changes at the tendon insertion sites of the humeral head tendon, in routine magnetic resonance imaging (MRI).Materials and Methods: Among patients whose shoulders were examined, using MRI, as a routine protocol, 200 were selected at random (mean age: 52 ± 13.3; range: 18-83), and were reassessed using the PACS system. Radiological findings of the rotator cuff tendons and humeral head cystic changes were recorded. The presence of cysts, their being single or multiple and the size of the largest cyst were also recorded. Coracohumeral and acromiohumeral distances were measured. Using SPSS 17.0 statistical package program; descriptive statistics, chi-square and t tests were performed. P-value less than 0.05 was set as statistically significant.Results: The most frequent pathology of the tendons was observed in the supraspinatus tendon and cysts were observed most frequently in the posterior greater tuberosity. Patients with pathologic findings in the rotator tendons and with cysts in the anterior greater tuberosity and lesser tuberosity were older as compared to those without any pathologic findings (p<0.05). The prevalence of cysts did not vary by sex (p>0.05). The mean age and the number of pathologic tendon findings did not vary between patients with and without a cyst in the posterior greater tuberosity (p>0.05). Of note, the mean coracohumeral distance was usually less than 10 mm and was shorter in patients with a cyst in the lesser tuberosity than in those without a cyst (p<0.05). The difference of the acromiohumeral distance between patients with and without a cyst on separate anatomical locations was not significant (p>0.05).Conclusion: As a conclusion, we found that cysts are most frequently observed in the posterior greater tuberosity and that this was not significantly correlated with either age or rotator cuff disorders. Additionally, we found that lesser tuberosity and anterior greater tuberosity cysts and tendon disorders are more frequently observed in patients of advanced age. Since none of the patients with an anterior cyst had a normal supraspinatus tendon, a relationship between anterior cysts and tendon disorders may exist. We also found that, lesser tuberosity cysts are observed more frequently in cases with shorter coracohumeral distance and that there is no relationship between the acromiohumeral distance and the presence of humeral head cysts.