Rotator Cuff Tears Research Paper

It is important to recognize partial or full thickness tears of the cuff, degenerative changes related to age, effusion, and calcifications. When evaluating tendons it is important to look for a “break” in the hyperechoic tendon, if this is seen it usually represents an injury such as a tear. Rotator cuff tears are a common finding in the aging patient. If the humeral head and acromion have direct contact there is indication of a massive cuff tear. Intrasubstance lesions are the most common partial thickness tears. With tears usually there will be subdeltoid bursal effusion. There can also be visualization of joint effusion. Rotator cuff calcifications can affect any of the tendons found within the rotator cuff, and can be visualized as solid, paste like, or liquid.
Tendons
Tendons are located throughout the entire body.
They are comprised of compact connective tissue consisting of collagen fibers. The peritenon is a layer of loose connective tissue that wraps around the tendon. Large tendons have lymphatics and vessels that course between septa, and small tendons have almost no vascularity. Tendons can attach to tuberosities, processes, or ridges. Synovial sheaths are double walled cylinder shaped structures the surround some tendons. Small amounts of synovial fluid can be found within these sheaths to act as a lubricant for the moving tendons. Large tendons do not contain synovial fluid. Tendons appear hyperechoic to surrounding anatomy on ultrasound. Sonography can be performed on tendons of the shoulder, elbow, hand and wrist, knee, foot and
ankle. While complete tears are rare, it is more common to see incomplete tears of the tendons. It is vital to diagnose a partial tear immediately to prevent complete rupture of the tendon. Tendinosis is a term for degenerative changes of a tendon. Tendinitis is inflammation of the tendon. This can be associated with athletes, or degenerative changes. Under ultrasound the tendon will appear thick, and will have poorly defined margins, and the echogenicity will be decreased. Ganglion cysts are often found in the hand and will appear as a round fluid collection. A standoff pad can be helpful when trying to evaluate theses cysts. Bakers cysts are relatively common and can be found behind the knee. Tumors of the tendons are relatively rare, and the echogenicity and echotexture can vary.