Value of anterosuperior rotator cuff and labral tears at MRI for predicting long head of biceps tearing at arthroscopy.

AIM: To determine whether magnetic resonance imaging (MRI) signs of subscapularis (SBT), supraspinatus (SST), or superior labral tearing predict long head of biceps (LHB) tendon tearing at arthroscopy. MATERIALS AND METHODS: Subjects with MRI studies followed by arthroscopy were collected. Radiologists graded rotator cuff (RC) tendons and the superior labrum using three grade classifications and blinded to arthroscopy. Correlation between imaging variables and surgical outcome was expressed in terms of odds ratios and determined using a stepwise logistic regression model. RESULTS: Selection criteria identified 89 participants. Statistically significant increase in odds of finding a partial LHB tendon tear at arthroscopy were noted for both MRI readers with any SBT tear (OR=4.1-5.6, p<0.0001 to 0.002), full-thickness SST (OR=8-20.4, p=0.002 to 0.006), and combined SST-SBT tears (OR=5.1-7.6, p<0.0001 to 0.002) and relative to grade 0 MRI scores for those categories. Statistically significant increase in the odds of finding any LHB tendon tear at arthroscopy were noted for both MRI readers with any SBT tear (OR=9.6 to 14.6, p<0.0001), full-thickness SST (OR=9.0 to 52.0, p<0.0001 to 0.0004) and combined SST-SBT tears (OR=8.2 to 15.1, p<0.0001) at MRI and relative to grade 0 MRI scores for these categories. No significant predictive effect was found for the labral categories. CONCLUSION: LHB tendons should be closely scrutinised if anterosuperior rotator cuff tears, and SBT tears in particular, are found on MRI.

A rare cause of calf swelling: the Morel-Lavallee lesion.

INTRODUCTION: Calf swelling is a common clinical presentation with a wide and varied differential diagnosis. The Morel-Lavallee is a rare cause of subcutaneous swelling, caused by post-traumatic shearing of the hypodermis from the underlying fascia. The potential space so created fills with blood, lymph and necrotic fat giving specific findings on MR evaluation. MATERIALS AND METHODS: A case of a 53-year-old man with calf swelling is presented, with clinical and MRI correlation. Treatment options and clinical course are discussed. CONCLUSION: The Morel-Lavallee lesion is a rare but important cause of calf swelling. MRI is the mainstay of diagnosis and treatment includes both surgical and minimally invasive modalities.