Citation, DOI, disclosures and article data
Citation:
Kabra U, Knipe H, Aponeurotic expansion of the supraspinatus tendon. Reference article, Radiopaedia.org (Accessed on 23 Mar 2025) https://doi.org/10.53347/rID-171310
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Integral Diagnostics, Shareholder (ongoing)
- Micro-X Ltd, Shareholder (ongoing)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Henry Knipe's current disclosures
The aponeurotic expansion of the supraspinatus tendon is an anatomical variant that is usually seen incidentally on imaging.
This structure can be seen in ~33% (range 19-49%) of shoulder joints imaged on MRI 1,3,4.
The aponeurotic expansion of the supraspinatus tendon represents a tendon-like structure arising from the supraspinatus tendon coursing in a vertical direction, along and parallel to the anterior aspect of the long head of the biceps at the level of the bicipital groove 1,2. It inserts distally, attaching to the pectoralis major tendon next to its humeral insertion 1,2.
Classification
A classification was proposed by Moser et al. 1:
type 0: absence of definite structure
type 1: thin flat (most common 3)
type 2a: oval; <50 % of the long head biceps tendon section
type 2b: oval; >50 % of the long head biceps tendon section
It can be easily mistaken for a bifid long head of biceps tendon and more importantly, an interstitial tear of long head of biceps tendon. Hence, the correct identification becomes important to prevent unnecessary intervention 1,2.
History and etymology
This structure was first described by Scottish anatomist and surgeon Charles Gordon Brodie (1860-1933) in 1890 1,4,5,6.
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1. Moser T, Cardinal É, Bureau N, Guillin R, Lanneville P, Grabs D. The Aponeurotic Expansion of the Supraspinatus Tendon: Anatomy and Prevalence in a Series of 150 Shoulder MRIs. Skeletal Radiol. 2015;44(2):223-31. doi:10.1007/s00256-014-1993-4 - Pubmed
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2. Boissonnault È, Chang M, Boudier-Revéret M. An Often Missed Finding in Ultrasonographic Shoulder Examination. J Med Ultrasound. 2021;29(1):68-70. doi:10.4103/JMU.JMU_40_20 - Pubmed
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3. Jo W, Park H, Kim J, Kim M, Shin H, Kang C. Aponeurotic Expansion of the Supraspinatus Tendon and Concomitant Shoulder Pathologies. Eur Radiol. 2023;33(7):4782-8. doi:10.1007/s00330-023-09399-1
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4. Akkaya Z, Gürsoy Çoruh A, Baş H, Gökmen D, Şahin G. A New Significance of an Old Structure: Aponeurotic Expansion of Supraspinatus Tendon and Its Relationships with Biceps Brachii Long Head and Rotator Cuff Tendons. Eur J Radiol. 2020;133:109374. doi:10.1016/j.ejrad.2020.109374 - Pubmed
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5. Brodie C. Note on the Transverse-Humeral, Coraco-Acromial, and Coraco-Humeral Ligaments, &c. J Anat Physiol. 1890;24(Pt 2):247-52. PMC1328049 - Pubmed
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6. Thomas Lathrop Stedman. Stedman's Medical Eponyms. (2005) ISBN: 9780781754439 - Google Books
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