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MRI can provide accurate detection of tendinous insertion of pectoralis minor
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According to researchers’ findings, preoperative MRI was able to accurately detect the 11% prevalence of tendinous insertion of the pectoralis minor.
The researchers recruited 99 patients to undergo arthroscopic exploration of pectoralis minor insertion. Two blinded observers reviewed preoperative MRIs for tendinous insertion of pectoralis minor twice within a 2-week interval, the results from which were correlated with arthroscopy as gold standard. The researchers then evaluated the effect of the variation on supraspinatus tendon tear and repair effect during arthroscopy.
Using the weighted Cohen к coefficient, the researchers determined intraobserver reproducibility and interobserver reliability.
Results showed 11 patients had tendinous insertion of the pectoralis minor. All patients were diagnosed with full-thickness rotator cuff tears, which were all repaired with arthroscopy. In eight patients, abnormal insertion of pectoralis minor tendon was observed, whereas in three patients, abnormal insertions were observed on the anterior supraspinatus.
MRIs results showed 13 tendinous insertions, with nine pectoralis minor tendons correctly diagnosed. The sensitivity and specificity for MRI diagnosis was 64% and 82%, respectively, and the accuracy was 80%, according to the researchers. The к value for intraobserver reproducibility and interobserver reliability was 0.445 and 0.437, respectively, both resulting in moderate agreement.
Seven pectoralis minor tendons restrained the retracted supraspinatus tendon from mobilization and led to undue tension in the tendon that had been repaired, which in turn required complete release of the tendinous insertion, according to the researchers. In four patients, there was no significant tension was found in repair; therefore, release of the pectoralis minor tendon was not required. ‒ by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.
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Lim TK, et al. J Shoulder Elbow Surg. 2015;doi:10.1016/j.jse.2015.03.003.
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