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Neovascularization Prevalence in the Supraspinatus of Patients With Rotator Cuff Tendinopathy

Kardouni, Joseph R. PT*; Seitz, Amee L. PhD, PT, DPT; Walsworth, Matthew K. MD; Michener, Lori A. PhD, PT, ATC*

Clinical Journal of Sport Medicine: November 2013 - Volume 23 - Issue 6 - p 444–449
doi: 10.1097/JSM.0b013e318295ba73
Original Research

Objective: A high prevalence of neovascularity in lower extremity tendinopathies has been reported. Neovascularity in those with rotator cuff tendinopathy exclusively has not been examined. The objective was to determine the prevalence of neovascularization in patients with rotator cuff tendinopathy compared with asymptomatic controls.

Design: Single-blind cross-sectional study.

Setting: Research laboratory.

Participants: Participants (n = 40; age = 44.9 years, 23-62 years; 20 females) with rotator cuff tendinopathy (n = 20) but without full-thickness rotator cuff tears, and asymptomatic controls that were age, gender, and hand dominance matched (n = 20) to the patients.

Interventions: The participants laying in supine had their shoulder positioned in internal rotation and extension. Ultrasound images were collected of the supraspinatus tendon and subacromial bursae in the transverse and longitudinal planes using a linear transducer in color Doppler mode.

Main Outcome Measures: Images were assessed for neovascularization by 2 trained raters who were blinded to group (rotator cuff tendinopathy or asymptomatic group).

Results: No statistically significant difference in neovascularization was identified between participants with and without rotator cuff tendinopathy (χ2 = 0.13, df = 1, P = 0.72). Neovascularization was identified in 6 of 20 patients with rotator cuff tendinopathy (30%) and 5 of 20 asymptomatic control participants (25%).

Conclusions: The authors found no differences in neovascularization rate in patients with rotator cuff tendinopathy (30%) and asymptomatic controls (25%). The study indicates that neovascularization is not related to presence of symptomatic tendinopathy in those with rotator cuff tendinopathy. Neovascularization may not be a relevant sonographic finding to aid the clinical assessment of those with rotator cuff tendinopathy.

*Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia;

Department of Physical Therapy, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts; and

Department of Radiology, UCLA Medical Center, Los Angeles, California.

Corresponding Author: Lori A. Michener, PhD, PT, ATC, Department of Physical Therapy, Virginia Commonwealth University, West Hospital, 1200 E. Broad St, Richmond, VA 23298 (

A. L. Seitz had a grant at the time of this research from the Foundation for Physical Therapy. L. A. Michener received funding from the National Athletic Trainers' Research and Education Foundation for another concurrent project during the time when data for this manuscript was collected.

L. A. Michener is on the board of directors for the Orthopedic Section of the American Physical Therapy Association, serves as a consultant for Expert Clinical Benchmarks, LLC, Philadelphia, Pennsylvania, and AT Still University Research Institute, Mesa, Arizona. For the remaining authors none was declared.

Received August 15, 2012

Accepted April 04, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.