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Skeletal Radiology

, Volume 47, Issue 8, pp 1127–1135 | Cite as

MRI of pectoralis major tears: association between ancillary findings and tear severity

  • Ivan R. B. Godoy
  • Edgar L. Martinez-Salazar
  • F. Joseph Simeone
  • Miriam A. Bredella
  • William E. Palmer
  • Martin Torriani
Scientific Article

Abstract

Objective

To evaluate the significance of biceps tendon (BT) displacement and peri-bicipital hematoma on MRI in subjects with pectoralis major (PM) tears. We hypothesized that these features might be associated with tear severity at surgery.

Materials and methods

We retrospectively identified MRI cases with PM injury and reviewed clinical, imaging, and surgical records. MR images were reviewed independently by two musculoskeletal radiologists to determine anterior displacement of BT (BT-disp, in mm) and the presence of triangular-shaped peri-bicipital hematoma. Data were compared with an age- and sex-matched control group and correlated with surgical reports grouped by tear severity.

Results

We identified 46 subjects with PM injury (43 men, 3 women; mean age 34 ± 9 years), 26 of whom underwent surgical reconstruction, and 20 matched controls (P > 0.2). BT-disp was significantly higher in PM injury vs controls (P = 0.003), and in tendon vs myotendinous (MT) junction PM tears (P < 0.0001); however, MT junction tears vs controls were similar (P = 0.98). Higher BT-disp and presence of peri-bicipital hematoma correlated significantly with surgical reports describing full-thickness complete tears. BT-disp > 4.5 mm had 86% sensitivity and 75% specificity to detect the most severe tears on surgical reports, whereas the presence of peri-bicipital hematoma was the strongest predictor among both parameters.

Conclusion

Anterior BT displacement and peri-bicipital hematoma are helpful indicators of full-thickness complete tears at the humeral insertion.

Keywords

Pectoralis major Tendon Myotendinous junction Strain Tear MRI 

Notes

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was waived for individual participants included in the study. The study was approved by the local Institutional Review Board (IRB) and was HIPAA-compliant.

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Copyright information

© ISS 2018

Authors and Affiliations

  • Ivan R. B. Godoy
    • 1
  • Edgar L. Martinez-Salazar
    • 1
  • F. Joseph Simeone
    • 1
  • Miriam A. Bredella
    • 1
  • William E. Palmer
    • 1
  • Martin Torriani
    • 1
  1. 1.Division of Musculoskeletal Imaging and InterventionMassachusetts General Hospital and Harvard Medical SchoolBostonUSA

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