Bursal lipohematoma: a CT sign of full thickness rotator cuff tear in patients with proximal humerus fractures
- 11 Downloads
The main purpose of the study is to determine if the presence of a particular computed tomography (CT) imaging finding, a bursal lipohematoma, portends the presence of a concomitant rotator cuff tear (RCT) in patients with proximal humerus fractures by reviewing previous CTs.
Three hundred eighty-six CT scans were retrospectively reviewed by two board-certified radiologists to determine the presence of a proximal humerus fracture and to assess for the presence of a subacromial/subdeltoid or subcoracoid bursal hematoma. The medical record including operative documentation was then examined in the patients with proximal humerus fractures, with or without a concomitant bursal lipohematoma.
Of the surgically managed patients, four had an intraoperative diagnosis of RCT. The preoperative CT scans of all of these patients demonstrated a bursal lipohematoma. Additionally, a non-surgically managed patient with a subacromial/subdeltoid bursal lipohematoma on CT scan was found to have a RCT on subsequent MRI. Of note, a rotator cuff tear was not documented in operative reports of patients with CT scans that were not found to contain a bursal lipohematoma.
Bursal lipohematoma is a potentially useful preoperative CT sign of full thickness rotator cuff tear in patients with proximal humerus fractures, providing the clinician with more information in the optimization of the management approach.
KeywordsProximal humerus Fracture Bursal lipohematoma Rotator cuff
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 5.Baudi P, Campochiaro G, Serafini F, Gazzotti G, Matino G, Rovesta C, Catani F (2014) Hemiarthroplasty versus reverse shoulder arthroplasty: comparative study of functional and radiological outcomes in the treatment of acute proximal humerus fracture. Musculoskelet Surg 98(1):19–25CrossRefGoogle Scholar
- 8.Ramappa AJ, Patel V, Goswami K, Zurakowski D, Yablon C, Rodriguez EK et al (2014) Using computed tomography to assess proximal humerus fractures. Am J Orthopedics (Belle Mead, NJ) 43(3):E43–E47Google Scholar
- 9.Bahrs C, Rolauffs B, Südkamp NP, Schmal H, Eingartner C, Dietz K, Pereira PL, Weise K, Lingenfelter E, Helwig P (2009) Indications for computed tomography (CT-) diagnostics in proximal humeral fractures: a comparative study of plain radiography and computed tomography. BMC Musculoskelet Disord 10(1):33CrossRefPubMedCentralGoogle Scholar