Partial Thickness Tear Of The Supraspinatus Tendon

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Partial Thickness Tear Of The Supraspinatus Tendon

Authors, Editors, Case Information Author: Jaime Dougherty, DO Affiliation: Cooper Medical School of Rowan University, Rowan School of Osteopathic Medicine Co Author(s): Altamash Raja, DO, RMSK, CSCS Senior Editor: Carlton Covey, MD, MEd Clinical Vignette: A 34-year-old male presented with 2 months of right shoulder pain exacerbated by overhead weightlifting and occasionally while sleeping at night. Physical exam was notable for pain with passive and active ROM in flexion and abduction. He had pain with empty can testing and with O-Brien's manuever. Sensation to light touch was intact throughout the C5-T1 dermatomes in the right upper extremity. Type of Probe Used: Linear Transducer 15-4 MHz Labeled SS tendon LAX Labeled right supraspinatus tendon in long axis Labeled SS Tendon SAX Labeled right supraspinatus tendon in short axis Unlabeled SS tendon SAX Unlabeled right supraspinatus tendon in short axis Unlabeled Right SS Tendon LAX Unlabeled right supraspinatus tendon in long axis Interpretation Image Interpretation: Findings: There is a focal, anechoic disruption of the interstitial fibers of the right supraspinatus tendon with possible extension to the articular surface, which measures 0.32 cm x 0.46 cm x 0.15 cm. No cortical irregularity is noted along the greater tuberosity. The subacromial bursa is not distended or thickened. On dynamic assessment, no bunching or distention of the subacromial bursa is noted. The biceps tendon is normal. No tendon sheath effusion is noted. The subscapularis is normal. The infraspinatus is normal. No fatty atrophy of the rotator cuff muscles. No effusion is noted in the posterior glenohumeral joint. Sonopalpation along the supraspinatus tendon reproduced the pain. Impression: Incomplete, partial thickness, interstitial tear within the belly of the supraspinatus tendon measuring 0.32cm x 0.46cm x 0.15 cm. Teaching Pearl: Rotator cuff tears generally present with an insidious onset of pain, worsening during overhead activities. Injuries range from 9.7% in individuals 20 years and younger to 62% in patients over 80 of age, regardless of symptom presence. The literature on the accuracy of ultrasound (US) in diagnosing partial-thickness rotator cuff tears (RCTs) is varied. Fotiadou et al. (2008) reported an 87% accuracy for US in detecting partial-thickness tears, compared to 90% for MRI. Rutten et al. found similar results, with US at 81% and MRI at 84%. Meta-analysis revealed no significant differences between ultrasound (US) and MRI in terms of diagnostic sensitivity, specificity, and accuracy for detecting partial-thickness supraspinatus tears. Both imaging modalities demonstrated comparable diagnostic performance in this context. Additionally, ultrasound is valuable as a cost-effective and accessible first-line tool, particularly in cases where dynamic assessment is beneficial.
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Authors, Editors, Case Information

Labeled SS tendon LAX

Labeled SS Tendon SAX

Unlabeled SS tendon SAX

Unlabeled Right SS Tendon LAX

Interpretation

UPCOMING EVENTS

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