POSTER ABSTRACTS - ISAKOS

minor and major changes during arthroscopic or
mini open repair.
Materials & Methods: We reviewed 66 patients of
rotator cuff tear treated from March, 2001 to
January, 2004. Of 38 cases of small to medium
tear, average age was 53 years old and involved in
dominant arm in 27 cases. Of 28 cases of large to
massive tear, average age was 58 years old and
involved in dominant arm in 26 cases. Minor and
major associated changes of the glenohumeral
joint were evaluated in the tendon of biceps long
head , biceps pulley, cartilage of the glenoid and
humeral head, labrum and synovium.
Results: Minor changes in biceps tendon were in
35% of cases, biceps pulley in 38%, cartilage of
humeral head in 27%, cartilage of glenoid in 18%,
labrum in 38%, and synovium in 42%. Major
changes in biceps tendon were in 6% of cases,
biceps pulley in 35%, arthritis of humeral head in
3%, arthritis of glenoid in 2%, labrum in 6%, and
synovium in 21%. Minor changes of biceps
tendon and glenoid cartilage, and major changes
of biceps pulley were more prevalent in large to
massive tear compared to small to medium tear.
Focal to generalized synovitis were identified in
55% of small to medium tear and 75% of large to
massive tear.
Conclusion: During arthroscopic examination of
rotator cuff tear, it needs careful evaluation in the
rotator interval including biceps tendon and
pulley. Focal to generalized synovitis were
prevalent regardless of the size of tear.
E-poster #1003
Groin Pain in the Athletes. Still a Challenge for
Imaging.
Kimmo T. Mattila, Turku, FINLAND, Presenter
Jouni T Heikkilu, Turku, FINLAND
Sakari Y Orava, Naantali, FINLAND
Turku University Hospital, MR ClinTurun
TeslaVagus, Turku, FINLAND
Groin pain in association with sports activities
continues to be a major problem in sports. The
incidence of groin symptoms varies depending on
the activity, in soccer it is 5-18% per year and in
football around 7%. Acute or chronic injury can be
a diagnostic and therapeutic challenge.
The pain may originate from several anatomic
structures such as muscles, tendons, ligaments
and bones, but additonally referred pain, nerve
entrapment, abdominal or gynecologic disorders
may cause similar symptoms.
Traditionally, X-rays have been used in acute
trauma to exclude acute avulsions. In most
conditions involving the groins and pelvis it still is
the first choice. In chronic disorders soft tissue
calcifications, joint space narrowing or
symphyseal irregularities help in focusing the
clinical examination and treatment. Additionally,
it gives an overview of the bone structures
excluding neoplastic processes masked by the
diagnosis of chronic groin strain. Computer
tomography gives important information in cases
with fractures and helps in preoperative planning.
Radionuclide studies have been used to detect
bone stress in the pubic rami or femoral neck.
However, nonspecific nature of the method is well
known, neoplasms, infection, osteoarthritis, or
entesopathy may cause identicallly increased
uptake as bone stress. Ultrasound has been used
in soft tissue pathology to detect muscle strains
and tendon avulsion. It is fast and easy in acute
trauma with hematoma and loss of function to
localize and grade the injury. Retracted tendons
and muscle tears are usually easily depicted as
well as bursitis, calcifications and joint effusion in
chronic cases.
Magnetic resonance imaging (MRI) has obvious
advantages such as lack of ionizing radiation,
multiplanar capability, high sensitivity and
specificity in bone and soft tissue patology. The
relatively high cost is the major disadvantage in
this examination. Especially on fat supressed T2
weighted (or STIR) images pathology is typically
depicted as bright signal intensity lesions. In
runners bone stress reaction in the ischial ramus
near the hamstring insertion is sometimes
associated with hamstring insertion tendinitis or
tendinosis, both easily discerned by MRI. More
commonly bony stress reactions may develop at
the symphysis pubis, or at the inferior pubic rami
adjacent to the symphysis. These injuries may be
related to overuse of adductor muscles.
Tendinitis, or more chronic tendinosis is common
at the insertion of adductor longus tendons,
especially in soccer or ice hockey players. Acute
tears at adductor insertions are easily
differentiated from tears at musculotendinous
junction. MRI is useful in determining the extent
of the injury. MRI discerns cases of acute iliopsoas
friction syndrome, or iliopsoas bursitis from hip
joint pathology such as labral tears or loose
bodies. Experience and technically adequately
performed examinations with thin slices and high
resolution images are needed to interpretate the
small pathological alterations correctly. Additonal