Qualitative analysis of the Supraspinatus muscle fatty infiltration on MRI - Correlation of the Tangent sign with Goutallier grade at the Y view and Medial Scapular border in large retracted rotator cuff tears

Surgically repairing rotator cuff tears with a higher extent of fatty infiltration (FI) is controversial. Current evidence supports performing rotator cuff repair in patients exhibiting Goutallier stage 3-4 FI. However, the presence of retraction complicates accurate assessment using the Goutallier Classification, particularly on the lateral Y-view. A shift toward classifying FI in more medial regions may enhance the precision of tissue quality quantification. The objective of this study was to analyze the uniformity of FI within the entire supraspinatus muscle using the Goutallier Classification across 3 scapular Y-view sections and to examine the association between Goutallier grade, tangent sign, and modified Patte stage.