How do MRI and radiograph findings correlate with clinical scores in patients with rotator cuff tears?

Background: Rotator cuff tendon tears are a common shoulder pathology, particularly among older adults, leading to significant pain, restricted movement, and shoulder muscle weakness. Despite the prevalence of asymptomatic cases, the correlation between clinical symptoms and radiological findings remains a subject of debate. Objective: This study aims to explore the relationship between clinical findings and radiological parameters in patients with full-thickness rotator cuff tears (RCTs). Methods: A cross-sectional study was conducted on 85 patients with symptomatic complete RCTs at Mansoura University, Mansoura, Egypt, from August 2018 to May 2020. Clinical assessments included the Shoulder Pain and Disability Index (SPADI) and Constant score. Radiological measurements involved acromio-humeral distance (AHD), critical shoulder angle (CSA), tear size, number of torn tendons, and fatty infiltration, evaluated using magnetic resonance imaging. Statistical analysis was performed to determine correlations between clinical and radiological findings. Results: Significant correlations were observed between clinical scores and radiological parameters. A smaller AHD (<6 mm) and larger tear size were associated with worse clinical scores. Better SPADI scores were significantly linked to a CSA of <35°. The number of torn tendons and fatty degeneration grades were also significantly correlated with clinical outcomes. Additionally, age and the duration of symptoms were associated with poorer clinical scores. Conclusion: The study highlights the strong correlation between radiological findings and clinical severity in patients with full-thickness RCTs. These findings underscore the importance of comprehensive radiological assessment in guiding the management of rotator cuff pathology. Furthermore, research studies with larger cohorts are needed to validate these results and explore the role of asymptomatic tears in clinical decision-making.