Humerus başındaki kistler ile rotator manşet ve biseps uzun başı tendonu patolojileri arasında bir ilişki var mı?

Year 2019, , 58 - 62, 31.03.2019

Mehmet Hamdi Şahan

https://doi.org/10.21601/ortadogutipdergisi.441876

Abstract

Amaç: Humerus başı tüberkül kistlerin lokalizasyonu ile rotator manşet ve biseps uzun başı tendonu patolojileri arasındaki ilişkinin araştırılması amaçlandı.

Gereç ve Yöntemler: Şubat 2014-Mart 2018 tarihleri arasında kliniğimizde çekilen omuz manyetik rezonans görüntüleri retrospektif olarak incelendi. Humerus başı tuberkül kisti olan 123 hasta çalışmaya dahil edildi. Büyük tüberkül, sagital görüntülerde humerus şaftına çizilen paralel çizgi ile ön ve arka olarak ayrıldı. Ön büyük tüberkül, arka büyük tüberkül ve küçük tüberkül olarak kistler üç gruba ayrıldı. Ayrıca kist boyutlarına göre 5 mm küçük ve 5 mm büyük olmak üzere ayrıldı. Rotator manşet tendonlarındaki patolojiler tam kat ve parsiyel yırtık olarak incelendi. Biseps uzun başı tendonundaki patolojiler tam kat/parsiyel yırtık ve tendinit-tendinozis olarak incelendi. 

Bulgular: Toplam 123 hastanın 57’si erkek (yaş ortalaması 50,49±11,8), 66’sı kadındı (yaş ortalaması 56,2±11,9). Ön büyük tüberkülde 50 (%40) hastada kist tespit edildi ve bu hastaların 41 (%82)’inde supraspinatus tendonunda yırtık mevcuttu. Ön büyük tüberküldeki kist boyutu 5 mm’den büyük olanların hepsinde supraspinatus tendonunda yırtık izlendi. Arka büyük tüberkülde 64 (%52) hastada kist mevcut olup infraspinatus tendonu ile anlamlı bir birliktelik saptanmadı. Küçük tüberkülde 22 (%18) hastada kist mevcuttu, bunlardan 10 (%45) hastada subskapularis tendonunda yırtık, 19 (%86) hastada biseps uzun başı tendonu patolojisi izlendi. 13 (%10,5) hastada farklı tuberküllerde kistler mevcuttu.  

Sonuç: Çalışmamızda, arka büyük tüberkül kistleri en sık görülen kistler olup yaş ve tendon patolojisi ile anlamlı bir ilişki bulunmadı. Ön büyük tüberkül kistleri olanlarda supraspinatus tendonunda yaygın olarak yırtık izlendi. Küçük tüberkül kistleri daha az sıklıkta görülmekte olup subskapularis tendon ve biseps uzun başı tendonu patolojileri ile birliktelik göstermektedir. 

Keywords

humerus başı, kist, rotator manşet, biseps tendon, manyetik rezonans görüntüleme

Is there a relationship between the long head of the biceps tendon and rotator cuff pathology with the humeral head cysts?

Abstract

Aim: The aim was to investigate the
relationship between the location of the humeral head tubercle cysts and the
rotator cuff, biceps long head tendon pathologies.

Material and Methods:
Magnetic resonance imaging of shoulder in our clinic between February 2014 and
March 2018 was retrospectively reviewed. Three hundred patients with the cyst
in the humeral head tubercle cysts were included in the study. The greater
tubercle was divided into anterior and posterior lines with a parallel line
drawn on the humerus shaft in sagittal images. The anterior greater tubercle,
the posterior greater tubercle and the lesser tubercle were divided into three
groups of cysts. Also according to the size of the cyst, it was divided into 5
mm small and 5 mm large. Pathologies in the rotator cuff tendons were examined
as full thickness and partial tears. Pathologies in the long head of the biceps
tendon were examined as full-thickness/partial tear and tendonitis-tendinosis.

Results: A
total of 123 patients were 57 male (mean age 50.49±11.8) and 66 female (mean
age 56.2 ± 11.9). The anterior greater tubercle cysts were found in 50 patients
and 41 (82%) of these patients had tears in the supraspinatus tendon.
Supraspinatus tendon tear were observed all patients with the anterior greater
tubercle cyst larger than 5 mm in cyst size. There were 64 (52%) cysts in the
posterior greater tubercle and no significant association with infraspinatus
tendon was detected. In lesser tubercle, 22 (18%) patients had cysts, and 10
(45%) of them had tears in subscapularis tendon, 19 (86%) patients observed the
long head of the biceps tendon pathology. Thirteen (10.5%) patients had cysts
in different tubercles.

Conclusion: In the
study, the posterior greater tubercle cysts are the most common cysts, and no
significant a relationship was found with age and tendon pathology. The
anterior greater tubercle cysts were observed widely torn in the supraspinatus
tendon. The lesser tubercle cysts are seen less frequently and are associated
with subscapularis tendon and the long head of the biceps tendon pathologies.

Keywords

humerus head, cyst, rotator cuff, biceps tendon, magnetic resonance imaging

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