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Greater Tuberosity Notch: An Important Indicator of Articular-Side Partial Rotator Cuff Tears in the Shoulders of Throwing Athletes^*

Shigeto Nakagawa, MD, PhD, Minoru Yoneda, MD, PhD, Kenji Hayashida, MD, PhD, Shigeyuki Wakitani, MD, PhD and Kenji Okamura, MD

Department of Sports Medicine, Osaka Kosei-nenkin Hospital, Osaka, Japan

Address correspondence and reprint requests to Minoru Yoneda, MD, PhD, Department of Sports Medicine, Osaka Kosei-nenkin Hospital, 4-2-78 Fukushima, Fukushima-ku, Osaka-city, Osaka 553-0003, Japan

We examined the location of rotator cuff tears, associated labral injuries, and notches on the greater tuberosity of the humeral head in shoulders of throwing athletes. Arthroscopic findings (rotator cuff tear, labral condition, and greater tuberosity notch) as well as other factors (duration of playing baseball, range of motion, and joint laxity) of 61 baseball players were retrospectively studied. The presence of a greater tuberosity notch was also evaluated for by plain radiographs. Forty patients had articular-side partial rotator cuff tears, most of which occurred in the interval between the supraspinatus and infraspinatus tendons. The existence of a rotator cuff tear was not related to the range of motion, joint laxity, the detachment of the superior glenoid labrum, or posterosuperior labral injury. Greater tuberosity notches were recognized in 38 shoulders by arthroscopy and most were detected on plain radiographs. The presence of a notch was significantly related to the existence of a rotator cuff tear, while the size of the notch was significantly related to the depth and width of the tear. The greater tuberosity notch seems to be one of the most important diagnostic indicators for a rotator cuff tear in throwing athletes.

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