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Last visited 04/19/2014 SUBSCAP AND SUPRASPINATUS TEAR Certified Random Case
Authored By: MSU Radiology, Mark C. DeLano M.D..
History: Left shoulder pain with limited range of motion for the past 2 months.
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Findings: There is an extensive full thickness tear of the subscapularis tendon which is nearly complete. A few stranding wavy fibers do appear to remain attached to the lesser tuberosity of the humerus. There is associated marked retraction and atrophy involving the subscapularis muscle. There is also mixed abnormal signal alteration seen along the proximal long head of the biceps tendon. The proximal portion of the long head of the biceps tendon is markedly diminutive within the superior joint capsule and only a few thin tendinous fibers are apparent extending to the bicipital labral complex. The superior labrum does remain intact, although there is increased signal within the labrum suggesting some degenerative changes. No actual superior labral tear is identified. There is a large partial tear of the supraspinatus tendon along the articular surface approximately 1.5 cm from its insertion on the greater tuberosity. There is also an extensive full thickness component to the tear along the posterior aspect of the tendon in this region. There is no associated muscle retraction with atrophic changes present within the muscle itself. There is a large joint effusion with extension of fluid into the subacromial/subdeltoid bursa. The subcoracoid bursa is also noted to be somewhat patulous and filled with fluid, likely related to the torn subscapularis muscle. There are mild degenerative changes of the acromioclavicular joint with osseous spurring and fibrous overgrowth of the capsule. In addition, there is some irregularity and fluid signal within the distal tip of the acromion suggesting additional degenerative changes versus fracture. Please correlate this finding clinically. Note is also made of lateral tilting of the anterior acromial process which is narrowing the acromiohumeral distance and likely contributing to the supraspinatus pathology.
Diagnosis: Subscap and supraspinatus tear.
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Case Number: 7562296Last Updated: 06/21/2013
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Anatomy: Skeletal System   Pathology: Trauma
Modality: MRAccess Level: Readable by all users
Contained in: All Public Cases, Fractures, Inbox
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Certified Certified by Gerald Aben on 04/06/2012