Rotator cuff tear Diagnostic modalities, dependent on circumstances, include X-ray, MRI, MR arthrography, double-contrast arthrography, and ultrasound. Although MR arthrography is currently considered the gold standard, ultrasound may be most cost-effective. Usually, a tear will be undetected by X-ray, although bone spurs, which can impinge upon the rotator cuff tendons, may be visible. Such spurs suggest chronic severe rotator cuff disease. Double-contrast arthrography involves injecting contrast dye into the shoulder joint to detect leakage out of the injured rotator cuff and its value is influenced by the experience of the operator. The most common diagnostic tool is magnetic resonance imaging (MRI), which can
Rectus sheath transversalis fascia, in contrast to the upper layers, where part of the internal oblique also runs beneath the rectus. Because of the thinner layers below, this region is more susceptible to herniation. Since the tendons of the internal oblique and transversus abdominis only reach as high as the costal margin, it follows that above this level the sheath of the rectus is deficient behind, the muscle resting directly on the cartilages of the ribs, and being covered only by the tendons of the external obliques. Rectus sheath The rectus sheath, also called the rectus fascia, is formed by the aponeuroses