This classification review describes the Goutallier system for grading fatty infiltration of the rotator cuff musculature — originally defined on CT, later adapted for MRI — examining its staging criteria, imaging methodology, reliability data across multiple studies, and prognostic role in guiding rotator cuff repair decisions.
When evaluating a patient for rotator cuff repair, grade fatty infiltration on the preoperative MRI using the parasagittal T1 image at the scapular spine–body junction: Stage 3 or 4 should prompt a frank conversation about limited functional recovery and elevated retear risk, and may shift your decision toward non-repair options.
Know that single-image grading and large reading panels both degrade reliability — your own consistent methodology matters more than the modality.
This classification review describes the Goutallier system for grading fatty infiltration of the rotator cuff musculature — originally defined on CT, later adapted for MRI — examining its staging criteria, imaging methodology, reliability data across multiple studies, and prognostic role in guiding rotator cuff repair decisions.
When evaluating a patient for rotator cuff repair, grade fatty infiltration on the preoperative MRI using the parasagittal T1 image at the scapular spine–body junction: Stage 3 or 4 should prompt a frank conversation about limited functional recovery and elevated retear risk, and may shift your decision toward non-repair options.
Know that single-image grading and large reading panels both degrade reliability — your own consistent methodology matters more than the modality.