Presentation
Right shoulder pain.
Patient Data
An articular-surface tear with an intratendinous horizontal splitting centred at the supraspinatus footprint/tendon attachment to the greater tuberosity mainly anteriorly with extension into the critical zone. It has about 10mm AP dimension, and >3mm depth, involving more than 70% of tendon thickness. Coracoacromial arch evaluation reveals: a type 2 acromial process with lateral tilt, reduced impingement interval to 5.5-6mm, and underlying supraspinatus tendon thinning. A low lateral acromial angle <66 degrees.
Degenerative changes within the horizontal intra-articular portion of the long head biceps tendon just at/distal to biceps–labral anchor, with no complete tear.
An area of increased signal intensity at the base of the superior labrum was noted from 11:00-1:00 as compatible with the SLAP lesion possibly extending into the biceps anchor.
Case Discussion
Rim-rent tear/partial articular surface supraspinatus tendon tear with the features of subacromial impingement related to type II laterally tilted acromion, however subacromial impingement is a clinical diagnosis and one should not diagnose or exclude it solely based on imaging.