Combined MRI-Based Morphometric Analysis in Patients with Supraspinatus Tendon Tears: A Comparative Study

Background/Objectives: Rotator cuff tears (RCT) are one of the most common causes of shoulder pain and loss of function. The aim of this study was to evaluate shoulder morphometric and soft tissue parameters using magnetic resonance imaging (MRI) and to compare them between patients diagnosed with RCT and symptomatic controls without MRI-evident RCT. Methods: In this retrospective study, shoulder MRI images of 64 patients diagnosed with RCT and 63 control subjects without RCT aged 20–80 years were analyzed. The critical shoulder angle (CSA), lateral acromial angle (LAA), acromial index (AI), coracohumeral distance (CHD), acromiohumeral distance (AHD), coracoacromial ligament (CAL) thickness, and supraspinatus tendon (SST) thickness were measured. Binary logistic regression analysis was applied to identify independent factors associated with RCT. Results: CSA was significantly higher in the RCT group compared to the symptomatic control group without RCT (36.18 ± 4.0 vs. 32.61 ± 2.6, p < 0.001). In contrast, CHD (7.06 ± 1.13 vs. 8.05 ± 1.30 mm, p < 0.001), AHD (6.15 ± 1.27 vs. 7.23 ± 0.99 mm, p < 0.001), and SST thickness (5.17 ± 0.69 vs. 6.89 ± 0.64 mm, p < 0.001) were significantly lower in the RCT group. No significant differences were found between the groups in terms of LAA, AI, and CAL thickness (p > 0.05). In the logistic regression analysis, increasing age (OR = 1.159; p = 0.044) and CSA (OR = 1.808; p = 0.005) were identified as independent risk factors, while an increase in SST thickness was identified as inversely associated with RCT (OR = 0.35; p = 0.003). ROC analysis demonstrated that SST thickness had the highest discriminatory performance (AUC = 0.963), while the combined multivariable model achieved an AUC of 0.979. Conclusions: CSA, CHD, AHD, and SST thickness are important morphometric and soft tissue parameters associated with RCT. In particular, the assessment of CSA and SST thickness may provide a more robust and clinically meaningful approach to RCT-associated changes. The combined evaluation of CSA and SST thickness may contribute to the understanding of morphometric associations related to RCT.