Rotator cuff tear

Case contributed by Maulik S Patel
Diagnosis almost certain


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

Patient Data

Age: 55 years
Gender: Male

There is subchondral sclerosis involving greater tuberosity of humeral head. 

Rest of the radiograph shows no abnormality.


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

The rest of the right rotator cuff tendons are intact. 

Right supraspinatus and infraspinatus 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 the right supraspinatus muscle suggesting that the tear is a recent event.

Ultrasound of the contralateral 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 the tear age group (>50 years of age). In this case, there was a tear of the left supraspinatus. 

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