MyPACS.net: Radiology Teaching Files > Case 4401116

never visited COMPLETE SUPRASPINATUS TEAR
Contributed by: Fritsch & Thompson.
Patient: 49 year old female
History:

Shoulder pain from exercising. R/O rotator cuff tear.

Images:[small]larger

Fig. 1: AP Internal Rotation View

Fig. 2: AP External Rotation View

Fig. 3: Axillary View

Fig. 4: Coronal PD Fatsat

Fig. 5: Coronal PD Fatsat

Fig. 6: Coronal PD Fatsat

Fig. 7: Coronal T2 Fatsat

Fig. 8: Coronal T2 Fatsat

Fig. 9: Coronal T2 Fatsat

Fig. 10: T1 Sagittal

Fig. 11: GRE T2* Axial

Fig. 12: GRE T2* Axial
Findings:
MRI examination reveals a full-thickness tear of the rotator cuff and supraspinatus best depicted on coronal images(posted above). There is approximately 1 cm retraction of the supraspinatus tendon with associated atrophy of the supraspinatus muscle. No fractures or osseous lesions are identified. There is a large effusion in the subdeltoid bursa communicating with the glenohumeral joint. Type I labral tear is identified on coronal images. The biceps tendon anchor remains adequately positioned. There is significant effusion, and distension of the biceps tendon sheath. There is a type II acromion present.
Diagnosis:
  1. FULL-THICKNESS SUPRASPINATUS/ROTATOR CUFF TEAR, WITH APPROXIMATELY 1 CM RETRACTION AND ASSOCIATED ATROPHY.
  2. EFFUSION OF THE GLENOHUMERAL JOINT COMMUNICATING WITH A LARGE EFFUSION OF THE SUBDELTOID-SUBACROMIAL BURSA.
  3. SLAP LESION.
Discussion:

http://www.orthop.washington.edu/uw/rotatorcuff/tabID__3376/ItemID__152/PageID__2/Articles/Default.aspx

http://info.med.yale.edu/ortho/ysmc/injuries/cuff.htm

http://www.aafp.org/afp/980215ap/fongemie.html

http://www.thefyldemedicalclinic.com/text/image_docs/shoulder/full_thickness_supraspinatus_tea.htm

http://images.google.com/imgres?imgurl=http://www.wheelessonline.com/image4/rocuf17.jpg&imgrefurl=http://www.wheelessonline.com/ortho/repair_of_supraspinatus_infraspinatus_tear&h=440&w=565&sz=25&tbnid=WoG8xpO4CQZ_-M:&tbnh=102&tbnw=131&hl=en&start=7&prev=/images%3Fq%3Dsupraspinatus%2Btear%26svnum%3D10%26hl%3Den%26lr%3D%26sa%3DN

http://images.google.com/imgres?imgurl=http://www.genufix.com/JM%2520RCT%2520mobility%2520assess.jpg&imgrefurl=http://www.genufix.com/rotator_cuff.htm&h=310&w=392&sz=7&tbnid=9P-haioslLPoCM:&tbnh=94&tbnw=120&hl=en&start=22&prev=/images%3Fq%3Dsupraspinatus%2Btear%26start%3D20%26svnum%3D10%26hl%3Den%26lr%3D%26sa%3DN

http://images.google.com/imgres?imgurl=http://catalog.nucleusinc.com/imagesthumbs/1670T.jpg&imgrefurl=http://catalog.nucleusinc.com/orderexhibit.php%3FID%3D1670%26I%3D%26A%3D2&h=121&w=160&sz=6&tbnid=Phv-5Uxwden6RM:&tbnh=69&tbnw=92&hl=en&start=45&prev=/images%3Fq%3Dsupraspinatus%2Btear%26start%3D40%26svnum%3D10%26hl%3Den%26lr%3D%26sa%3DN

References:

Referring Physician:  Peggy Bolks, DC

DRH Case of the Week 6/14/06

Comments:
No comments posted.
Additional Details:

Case Number: 4401116Last Updated: 06-14-2006
Anatomy: Skeletal System   Pathology: Trauma
Modality: Conventional Radiograph, MRExam Date: 04-10-2006Access Level: Readable by all users
Keywords: shoulder tear, supraspinatus tear, ligament tear

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