Rotator cuff (RC) injuries are a common cause of shoulder pain and dysfunction. Their multifactorial etiology includes anatomical and clinical factors. This study evaluates the utility of various radiographic indices in detecting RC tears and explores their correlation with the condition of the long head of the biceps tendon (LHBT). A cross-sectional study was conducted with 150 patients assessed using shoulder radiography and ultrasound. Variables analyzed included acromial slope (AS), acromial tilt (AT), acromial index (AI), subacromial distance (SD), lateral acromion angle (LAA), and critical shoulder angle (CSA). Associations were examined through logistic regression, and predictive models with and without the variable “Age” were compared.
Most injuries affected the supraspinatus tendon and were full tears (72.1%). CSA (OR = 0.798, p < 0.001) and SD (OR = 0.559, p < 0.001) were the main predictors of RC tears, along with Age (OR = 1.065, p = 0.003). The model including Age demonstrated better discrimination (R² = 0.601). LAA showed a protective trend (p = 0.053), while AT, AS, and GP showed no significant associations. This investigation highlights the critical role of specific radiographic measures, particularly CSA and SD, in diagnosing RC tears with age as a significant enhancer of tear likelihood. The findings challenge the conventional utility of several acromial indices and reinforce the interconnectedness of RC pathology with alterations in the LHBT. These insights pave the way for refined diagnostic strategies in clinical settings.
