Medial scapular body (MSB) Goutallier classification: MRI-based reliability and validity of evaluation of the Goutallier classification for grading fatty infiltration of the rotator cuff

The degree of atrophy and fatty infiltration of rotator cuff muscle belly is a key predictor for cuff repairability. Traditionally, Goutallier grading of fatty infiltration is assessed at sagittal scapular Y-view. Massive rotator cuff tears are associated with tendon retraction and medial retraction of cuff musculature, resulting in medialization of the muscle bulk. Thus, standard Y-view can misrepresent the region of interest and may misguide clinicians when assessing repairability. It is hypothesized that by assessing the muscle belly with multiple medial sagittal magnetic resonance imaging (MRI) sections at the medial scapular body, the Medial Scapular Body-Goutallier Classification (MSB-GC) will improve reliability and repeatability, giving a more representative approximation to the degree of fatty infiltration, as compared with the original Y-view.