โœ… Shoulder MRI/Chap 1. Rotator Cuff Part 1

Rotator Cable vs. Coracoacromial Ligament on MRI: How to Avoid Common Misinterpretations and Improve Shoulder Tear Diagnosis

MSK MRI 2025. 1. 12. 19:56

https://youtu.be/GLGz8BKbacQ

๐Ÿ“Œ Rotator Cable Overview

The rotator cable is a thick, fibrous structure in the shoulder, resembling a suspension bridge. 

It transfers forces across the rotator cuff and helps anchor the tendons to the tubercles of the humerus.

 

โœ… Function of the Rotator Cable

  • Anchors rotator cuff tendons to the humerus.
  • Assists in stabilizing the glenohumeral joint.
  • Disperses stress on the rotator cuff tendons, protecting them from excessive strain.

 

โœ… Clinical Significance on MRI

Sheah et al. observed that a prominent rotator cable on routine MRI is often associated with partial articular surface tears of the rotator cuff. 

A visible rotator cable may indicate:

  • Tendon retraction.
  • Undersurface tendon delamination.
  • Reduced tendon quality and weakened rotator crescent, suggesting a loss of stress shielding.

When a rotator cuff tear is suspected, but not definitively seen on imaging, visualization of a prominent rotator cable can serve as an ancillary sign to support the presence of a tear.


References

AJR Am J Roentgenol. 2013 May;200(5):1101-5.

EFORT Open Rev. 2019 Feb 20;4(2):56-62.

Sheah et al., AJR Am J Roentgenol. 2009 Sep;193(3):679-86.

MRI Web Clinic โ€” February 2013, Rotator Cuff Pitfalls, Mark H. Awh, M.D. (https://radsource.us/rotator-cuff-pitfalls/)


 

#RotatorCable, #ShoulderMRI, #RotatorCuffTear, #OrthopaedicImaging, #RadiologyEducation, #MRIInterpretation, #GlenohumeralJoint, #RotatorCuff, #ShoulderAnatomy, #RadiologyInsights




๐Ÿ“Œ  Coracoacromial Ligament (CAL) 

The coracoacromial ligament is a key component of the coracoacromial arch.

It is a triangular band composed of two fascicles.

The coracohumeral ligament is a thick bundle of fibers running perpendicular to the supraspinatus tendon fibers.

 

  • Origin: Lateral aspect of the coracoid process.
  • Insertion: Anterior, lateral, and inferior surfaces of the acromion.
  • Function:
  • Connects the acromion and coracoid process of the scapula.
  • Strengthens the superior portion of the shoulder joint capsule.

 

Clinical Significance

  • Coracoacromial Ligament Ossification or Thickening:

References

AJR Am J Roentgenol. 2013 May;200(5):1101-5.

EFORT Open Rev. 2019 Feb 20;4(2):56-62.

Sheah et al., AJR Am J Roentgenol. 2009 Sep;193(3):679-86.

MRI Web Clinic โ€” February 2013, Rotator Cuff Pitfalls, Mark H. Awh, M.D. (https://radsource.us/rotator-cuff-pitfalls/)


๐Ÿ“Œ Key Points to Avoid Misinterpretation

  1. Do not confuse the rotator cable with retracted tendon fibers:
    A true rotator cable extends from the anterior attachment at the greater tuberosity to the posterior oblique facet insertion on axial images.

 

  1. Carefully assess the level of the image:
    At higher axial levels, the coracoacromial ligament can sometimes appear with a similar orientation, so confirm the level is at the supraspinatus anterior and posterior intramuscular tendons.

 

#CoracoacromialLigament, #ShoulderAnatomy, #RotatorCuffTear, #SubacromialImpingement, #ShoulderMRI, #OrthopaedicImaging, #CoracohumeralLigament, #RadiologyEducation, #ShoulderStabilization, #RadiologyInsights

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