Infraspinatus tendon tear

Last revised by Yahya Baba on 12 Mar 2023

Infraspinatus tendon tears are rotator cuff injuries affecting the infraspinatus tendon generally associated with other rotator cuff tears and are usually due to degenerative processes, trauma, or constant overhead motion strain 1.

Isolated full-thickness infraspinatus tendon tears are very uncommon 2. They are usually associated with supraspinatus tendon tears.

Patients will present with shoulder pain and tenderness along the infraspinatus tendon. They might present with a weakness in the affected arm and a limited range of motion.

Associated conditions include:

A modification of the original Codman classification may be used to categorize tears:

Calcific tendonitis around the greater tubercle may be seen.

Joint effusion and loss of the acromiohumeral interval could be seen in massive rotator cuff tears.

Ultrasound can be considered for initial assesement of the infraspinatus tendon. Although it is sufficient for the diagnosis of full thickness tears, some partial tears may be underdiagnosed.

MRI is the modality of choice in the diagnosis and the pre-operative planning of infraspinatus tendon tears as it demonstrates the tear, it's location, size and all associated lesions.

The radiological report should include a description of the following 3:

  • location and size of the tear

  • tear pattern and extent

  • tendon retraction

  • rotator cuff associated tears

  • level of muscle fatty degeneration

  • acromioclavicular joint osteoarthritis

Infraspinatus tendon tears could be managed conservatively or surgically, based on the patient age, size of tear, activity level, and mechanism of tear 4.

Possible considerations on low resolution modalities include

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