MRI of the Rotator Cuff

The rotator cuff is a common source of problems in a patient's shoulder. In the appropriate situation, a MRI scan may be ordered to better understand the cause of pain or disability. Unlike a regular x ray, the MRI will be able to see other structures in the shoulder such as the rotator cuff tendons, muscle and cartilage.
This video will review the rotator cuff anatomy as well as how to identify the rotator cuff on a MRI and understand its normal appearance on the scan. Students in allied healthcare, radiology, medical students, residents as well as patients will hopefully find this video useful.
In order to best understand the information a MRI provides, a solid knowledge of the anatomy is crucial and time is spent reviewing that in this video.
_________________________________________________________________________
Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure.
All patients have been consented for use of any imaging, video, or other media.

[@viveenesmie163]

I am in so much pain right now while watching this video! My right shoulder really hurts. i am not able to fix it comfortably to even sleep at nights . The video is very informative but i need to get help with this pain.

[@ambrosepalmer3227]

This is the best explanation ever with a view of the animated view next to the MRI. Excellent illustration. Also well articulated.

[@JeffreyWittyMD]

Glad it was helpful!

[@monicakeller7494]

agree 100%

[@rollieevans6292]

Very informative. Nine years ago I was diagnosed with a full thickness tear with retraction and severe muscular atrophy. Surgeon wanted to do a reverse shoulder replacement but after discussing the limitation I said no way. Today I have no pain, I can swing a hammer, and do almost anything I need to do. I don't have a lot of strength directly in front of my body. I still do some farming and still fighting fires as a volunteer firefighter at age 72.

[@denisemariner1235]

42 year veteran RN...stellar presentation. Thank you.

[@tamevauch5948]

Rotator cuff pain is no freeken joke. I've been brought to tears from this pain. Unfortunately, I cannot do anything about it. I did get a cortisone shot, felt ok after that but didn't last long. I'm learning to live with it.

[@lawrencegoldman4347]

One of the best descriptions of the MRI of a shoulder rotator cuff tear. Bravo!

[@keithdavis4997]

Well done. The anatomical models next to the MRIs and the scrolling back and forth provide very good context for understanding the anatomical relations.

[@user-ed9ql9oe6d]

Thank you! An excellent description of the anatomy and how the 3 MRI perspectives provide visibility of the structures and attachments through the shoulder.

[@treesnbikes]

Best presentation of the shoulder structure I have ever seen! Three weeks out from a fractured scapula and it is really helping me understand the bigger picture. And helping my relief knowing that the rotator cuff survived my bike crash with minimal impact

[@JeffreyWittyMD]

Thanks. I'm glad this was helpful for you.

[@timothyhitchcock1679]

A truly excellent teacher. Thank you.

[@ivalani]

Best visual explanation of the rotator cuff structure.

[@queenlioness7056]

Thank you so much for this video. It helps me understand where my rotator cuff tears are when I look at my MRIs.

[@LeroyYue]

Excellent video! thank you

[@hhspore]

I am a shoulder replacement patient and watching your very well presented video helps me to understand my MRI imaging. Excellent education. Thank you very much. From Singapore. PS I hope that you can create a video to show the various classifications of tears eg what size is considered small. medium. large. x large and at what point a surgery is a likely option rather than repair. Many thanks Doctor Witty !

[@smatlanta1]

Wow! That was an amazingly clear presentation. Thank you.

[@margaretmeaker2830]

Brilliant video.. u brought it down to a level that everyone could understand- that's not easy to do.. thank you very much. Pity can only give 1 thumbs-up

[@mitrasaid8413]

Thank you!! it really made me understand different views in such a simple way!

[@arbiter3297]

Great instructional video. Thanks for your superb effort and clear explanation.

[@paulflowers4504]

Very good job man got an MRI yesterday with the CD home i had no clue but you explained it thanks 👍

[@sylvesterpalermo937]

Well Darn, I am a retired Dentist and I had such a problem with these because with a radiograph the areas of density are white( unexposed film) and less dense are darker. These images are exactly the opposite. Now I understand, I was still thinking as a Dentist. I also love the study anatomy and coincidentally I will have PRP injections next week for this very problem. Thank you for this marvelous explanation.

[@TheCarolgibbons]

Very comprehendible, thank you!!!

[@caiyu538]

Great lecture. One of the best lectures in this topic for me.

[@JeffreyWittyMD]

Glad it was helpful!

[@sonyyoung1036]

I am getting MRI of the shoulder and appreciate the level of detail you provide. I hurt my shoulder on a fall during a hockey game. Its odd that I am most uncomfortable while sleeping and not during the day. In addition, it seems I have lost some muscle tone on the scapula. Thank you for this information.

[@stevengilman]

My wife was just diagnosed with a rotator cuff partial tear. I am trying to understand what might be going on in the shoulder and, in general, understanding the shoulder anatomy. This was a wonderful overview and enlightening presentation. I also understand and orientated to some of the anatomy of my recent sub acromial decompression procedure. Thank you Dr. Witty.

[@JeffreyWittyMD]

Steven, I'm really happy this helped you. I hope to complete the series in the next few months and will go over partial tears as well. I hope your wife does well!

[@Wazup4177]

Fantastic explanation!

[@jeaniebrandt8823]

Dr. Witty you have provided an excellent explanation of the rotator cuff and the MRI. Thank you. I understand so much more about my own injury as I approach surgery in a few days.

[@JeffreyWittyMD]

Jeanie, Thanks for the comment. I hope your surgery went well. I am glad you found the video helpful! All the best.

[@akolkar2530]

Thank you Doctor for all detailed video I must say this video is encyclopaedia of shoulder anatomy .Everyone must. watch.👌👌👌👌👌

[@mikecar52]

Thank you. Excellent video.

[@marcelorodriguez7524]

Great detail explanation, thanks

[@roneckler9937]

I tore the Labrum in my shoulder back in 2018. I still have the images of the tear. Now I understand the different views and why the doctor used those images. They are the exact images you paused at when explaining the MRI's. Thank you for your video Dr. Witty!

[@JeffreyWittyMD]

Thank you for the feedback! Hopefully I can continue to add to the library. All the best.

[@monicakeller7494]

Best explanation ever!!!

[@AIMEEMCSPARKLY]

Excellent explanation for a lay person! Graphics super helpful. L shoulder arthroscopy coming up next week! Appreciate the tutorial!

[@einfelder8262]

Excellent video. My injury was diagnosed as a 50% articular side partial thickness rim rent tear of the supraspinatus tendon insertion located 2mm behind the bicipital groove measuring 7mm in mediolateral and 10mm in AP diameter. Phew! A mouthful. But I can now visualise where it actually is, and make sure I don't repeat the action which caused the injury.

[@saltyolbroad2962]

This is really neat, so far! I tore all 4 rotator cuff muscles, in both arms (naturally, at the same time)! I literally could not use my arms! My arms just would not move when I tried - which is a very strange feeling to experience! Surgeon reattached them all. Outcome was quite good but I'm still super weak when it comes to lifting. Now I can see what they re-attached!

[@user-io8eq1gg5p]

Best explanation ever!

[@user-wr6vl7qs8f]

very well Explained -Thanks

[@westfield90]

So helpful. Thank you

[@nancye7520]

Fantastic-thank you.

[@jenningsedwards2303]

Absolutely great explanation...

[@JeffreyWittyMD]

Glad it was helpful!

[@connietomlinson6391]

Wow, very informative and interesting

[@KirstenLeounes]

This is the best explanation of the rotator cuff I have ever seen!! Kudos to you!! I agree you should consider a career in teaching. I am a teacher as well.

[@JeffreyWittyMD]

Thank you!

[@GaleusLeonidus]

Great explanation sir. Love from Pakistan

[@kcdirectbuysmart8324]

Made a very complicated topic somewhat understandable to the layman.

[@Fredlocal80]

thanks doc.

[@johncasale2195]

This is the doctor surgeon that others should follow by what a great man u will be using him if I could I live in bklyn ny and will travel

[@MikeInBeantown]

THANK YOU !

[@togetherness2000]

This was informative. Thank you.

[@devjichawda9091]

Thanks a lot.

[@D3R3LICTRECORDS]

Fascinating.

[@petermartin9782]

you are brilliant - so clever and well explained

[@JeffreyWittyMD]

Thank you.

[@bijoyshaw7777]

Very well explained

[@JeffreyWittyMD]

@bijoyshaw7777, Thanks for the feedback.

[@kimfalsetti5618]

Thank you for sharing and explaining, now I have more of an idea what is going on with my full and partial tears…

[@bhardwajparitosh]

Very nicely explained....

[@JeffreyWittyMD]

Glad you liked it

[@behnamzadeh1936]

very good subject thanks

[@JeffreyWittyMD]

Thank you.

[@doreenmorawski3484]

Excellent! Has to be the best explanation and visuals on the internet.

[@JeffreyWittyMD]

Thank you.

[@adrnln_jnke]

What a great and helpful explanation of the MRI. I recently had surgery to repair my >70% tear in my supraspinatus tendon, bicep tendon and Labrum. My Question to you is, what does a partially torn ligament look like in the MRI? Thank you

[@MuhammadAsif-vj5bm]

great dedicted work

[@JeffreyWittyMD]

Thank you!

[@burtd24]

Nice simple surgical approach to rotator cuff and complexities..add ligaments, vessels, fluid and pathology and all this affects identification of all the anatomic structures. thank u love the model of shoulder you use. Do you a video on the biceps pulley?

[@JeffreyWittyMD]

@burtd24, A video of the biceps pulley would be a good idea. I'll add it to the "to do" list!

[@MoonFlowers0107]

I’ve had 2 tears since right before the pandemic. So no MRIs or assistance until like 2021.. my shoulder and arm muscle was weakening worse and worse.. couldn’t sleep properly for years. Only recently was I able to start strengthening the necessary areas so I can actually get what I need to get done. It’s been a long and exhaustive road. Advice to anyone, don’t ever EVER let this injury linger. Seek an orthopedist ASAP.

[@martinfromseacity2010]

Thanks I've been wondering whats going on in my shoulder

[@sessiondrummer]

This is a superbly educational video for those of us who are not medically trained. I am having a private MRI soon and am Interested in what it will show. Following a heavy cricket season I fear I may have a bad tear, so I’m interested in learning as to what a tear looks like. Hoping mine isn’t too bad (if I have one at all…). Do you have a video showing a tear?

[@JeffreyWittyMD]

Thanks for the comment. I do have a video on identifying tears on MRI. I go over all sorts of tear sizes and types on it. Hopefully you will find it helpful. Here is the link: kzbin.info/www/bejne/oqHJm5aEadZjhq8 Cheers

[@darlenehogan7475]

I'm facing reverse shoulder replacement this coming week. I've been in extreme pain for 5 months now.

[@mangos2888]

If you're not a teacher, you should be. Thank you!

[@arphaksad01]

Wow. Great video. It's like going to med school. And the labrum holds the arm ball in place. Looks like all the entire muscle group should be worked for shoulder health.

[@JeffreyWittyMD]

Good morning, The labrum does play a role in helping to stabilize the ball (humeral head) on the socket (glenoid). The capsule (essentially the lining of the joint) and the ligaments attach to this location. In addition to these more static stabilizers, the shoulder joint has dynamic stabilizers. This is the function of the rotator cuff. Check out some of my other videos on that anatomy. The rotator cuff surrounds the ball and socket and compresses the ball into the socket which provides shoulder stability. Think of pushing a golf ball down into the tee. With that pressure it will be harder for the ball to roll off the tee. The rotator cuff provides that function to the glenohumeral joint.

[@arphaksad01]

@@JeffreyWittyMD Thank you so much. I had a rotator cuff repair about 5 years ago and now the repair is broken. Thanks again

[@stevemerrill7430]

Thank you. I would like to see a view of what the MRI looks like with a torn Supraspinatus

[@JeffreyWittyMD]

We have some videos for that!

[@jaspersanfellipo7184]

Thanks for the detailed walk-through, Dr. Witty. Were there any tears in the rotator cuff on the shoulder imaging you used in the demo? I am assuming "no" because you would have pointed those out. I'm curious to see examples of partial or full-thickness tear in an MRI.

[@JeffreyWittyMD]

Thanks for watching, No, there are not any substantial tears on the imaging used. I do have a video demonstrating tears of various sizes on MRI... see the link below: kzbin.info/www/bejne/oqHJm5aEadZjhq8

[@jaspersanfellipo7184]

@@JeffreyWittyMD Thank you so much, Dr. Witty. Five minutes after I wrote that message to you, I saw your other video that features the tears of various sizes. :-) Very helpful.

[@micheleerwin2848]

I'm on a 6 month waiting list to have my right shoulder replaced. My MRI shows a massive tear in my rotator cuff and bicep. I've already had both knees and my right hip replaced. I now need both shoulders replaced. I'm getting a brand new body, one part at a time.

[@dave-rf2vn]

Me too just had surgery Feb14 lots going on there with tears and normal wear

[@FlexBicep]

Can you give me some advice on the following MRI that I recently had? Thank You CONCLUSION: 1. Frayed deep near full thickness 1.6cm tear supraspinatus interstitium and bursal surface. Mild bursitis. 2. Chronic Hill-Sachs lesion. Scarred anterior inferior labroligament complex. No acute macroinstability. 3. AC arthropathy. Pseudocysts and marrow reaction distal clavicle and acromion related to overuse. Low lying acromion. Lateral arch narrowing.

[@JeffreyWittyMD]

@FlexBicep, 1. The supraspinatus is one of the four rotator cuff muscles. There is a tear described as "near full thickness". They are stating that this portion of the tendon is nearly torn from the bone. You can think of the bursa as sort of a low friction tissue layer around the rotator cuff. Bursitis refers to inflammation of this. 2. A Hill Sachs lesion is a depression in the humeral head (ball of the socket). This usually occurs when the shoulder is dislocated at some point. The anterior inferior labroligament complex is a stabilizing ligament of the shoulder. Scarring suggests prior injury such as a shoulder dislocation. 3. AC = acromioclavicular joint which is the small collar bone joint to the shoulder blade (scapula). Arthropathy = osteoarthritis which is when the cartilage end of the bone starts to wear out. Hope that helps! _______________________________________________________________________ Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure.

[@joegutierrez2659]

I had an spinal surgeon sugguest Cervical C5-C6(MRI)surgery due to my severe shoulder/Arm pain, I just had an MRI of the shoulder which shows 2 full width tears in two of the tendons and the head of my bicep tendon is dislocated, the spinal surgeon still insists my pain is due to the problem in my neck but I'm having a shoulder specialist review the new MRI. Note; I've been suffering from this severe pain and limited right arm use for 10 months now.

[@JeffreyWittyMD]

Thanks for the question, The description you provided about your MRI suggests a significant tear of the rotator cuff and biceps. That could definitely be a cause for pain and difficulty with your shoulder. However, it is very possible that you have symptoms related to your neck as well. I commonly see this in my practice. Symptoms from neck problems will commonly overlap the shoulder and, in my opinion, it is important to clarify all sources of your pain prior to making treatment decisions. It sounds like you have the right people involved (spine surgeon and a shoulder specialist). I will commonly discuss a patient with our spine surgeon to see which area needs treatment first and is more time sensitive. _________________________________________________________________________ Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure.

[@joegutierrez2659]

@jeffreyb.wittym.d.7528 , Thank you very much sir, after meeting with both doctors, I believe we've come to a good solution. Your input is deeply appreciated!

[@Excuse_The_Hebrew]

Is there surgery for this type or injury? I’m going for a MRI soon

[@JeffreyWittyMD]

Good afternoon, Yes, there is a surgery. We typically perform rotator cuff repair via arthroscopic surgery. Arthroscopic surgery is when we use small incisions and place a camera into the shoulder. Good luck with the MRI!

[@HeavyHaul51]

I scheduled for a reverse shoulder replacement March 20-24. All 4 tenons are detatched and the ball shifted and worn down.

[@JeffreyWittyMD]

Sorry to hear about your shoulder. A very large rotator cuff tear with a "worn down" joint (i'm assuming this means osteoarthritis of the shoulder joint) should do very well with a reverse shoulder replacement. Good luck!

[@imjustpassinthru]

After all of that no images of a torn rotator cuff tendon. Or did I miss that part?

[@JeffreyWittyMD]

imjustpassinthru, Thanks for the comment. My goal in this video was to show what a normal rotator cuff looked like. I hope to get around to a video demonstrating tears on MRI as well. Trying to get videos done as soon as I can. Hopefully, I can get back to them soon!

[@Sharon-yk7xm]

They told me mine would heal in time after my accident in 1984 its now 2024 it never healed so very painfull

[@bonnyschumaker522]

Your axial view seemed to be from the bottom, not the top, so it looked more like a left not right shoulder, no? That got me really confused…

[@JeffreyWittyMD]

Good question, In regards to the position of the model the video, you are correct. Because of the limitation of the model, I decided to hold it with the bottom part facing the viewer. This only serves to show how the tendons attach to the humeral head and the humeral head's relation to the glenoid on an axial view. The axial view of the MRI most closely approximated holding the model in that orientation. The orientation is still correct however. The subscapularis is to the right and the infraspinatus and teres minor to the left. When scrolling through the various images on MRI you can think of it as scrolling from top to bottom or bottom to top. Hopefully that answers your question.