Full thickness supraspinatus tear (MRI arthrogram)

Case contributed by Dr Dai Roberts

Presentation

?SLAP tear

Patient Data

Age: 45 years
Gender: Male

Full-thickness, partial width tear of the distal supraspinatus tendon which involves the anterior and mid tendon, with retraction from its insertion to the level of the acromion.  The gadolinium containing injectate decompresses from the glenohumeral joint into the subacromial subdeltoid bursa through the full-thickness tear. 

The proximal long head of the biceps tendon partially subluxes out of the bicipital groove and into the mid subscapularis enthesis, and then fully cleaves into the superior and lateral tendon above the bicipital groove. The bicpitolabral anchor is intact. 

No Hill-Sachs defect or labral tear.  Normal glenoid morphology.  Intact axillary pouch portion of the capsule.

Case Discussion

Gadolinium containing arthrogram injectate within the subacromial-subdeltoid bursa will have a pronounced appearance on MR arthrography, due to the intentionally performed T1 fat-saturated sequences. 

Arthrogram injectate within the subacromial-subdeltoid bursa will occur more commonly due to a full-thickness rotator cuff tear, leading to decompression of the arthrogram injectate into the bursa.  Less commonly is the iatrogenic injection into the subacromial-subdeltoid bursa

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