Rotator cuff tear

Case contributed by Dr Maulik S Patel

Presentation

Fall from bike 4 weeks ago. Complaining of right shoulder pain.

Patient Data

Age: 55 years
Gender: Male
Modality: X-ray

There is subchondral sclerosis involving greater tuberosity of humeral head. 

Rest of the radiograph shows no abnormality.

Modality: Ultrasound

There is a fluid filled defect replacing entire full thickness and entire width of right supraspinatus suggesting tear. The defect length or retraction is 30 mm.

Rest of the right rotator cuff tendons are intact. 

Right supraspinatus and infraspiantus muscle bellies show normal volume without fatty infiltration.

Asymptomatic left shoulder was examined for comparison : full thickness tear of supraspinatus present.

Case Discussion

Findings of post traumatic right supraspinatus tendon complete ( full thickness and full width ) tear with 30 mm retraction.  There is no atrophy or fatty infiltration of right supraspinatus muscle; suggesting that tear is recent event.

Doing ultrasound of contra-lateral shoulder; may or may not be part of your protocol. However, when there is a large tear like this ( 30 mm retraction ),  contralateral cuff is more likely to show pathology mainly in tear age group ( > 50 yrs age ). In this case, there was tear of left supraspinatus. 

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Case Information

rID: 17937
Case created: 26th May 2012
Last edited: 1st Jun 2016
Inclusion in quiz mode: Excluded

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