SLAP tear

Case contributed by Dr Utkarsh Kabra

Presentation

History of fall.

Patient Data

Age: 45 years
Gender: Female
MRI

Bone contusion with marrow edema involving greater tuberosity

Partial-thickness articular surface tear of posterior fibers of the supraspinatus tendon is seen at foot print attachment site, possibly extending to conjoint tendon and anterior fibers of the infraspinatus and involving approx. 30% thickness. No obvious atrophy of supra, infraspinatus muscles is noted. 

Significant hyperintensity and edema is seen in the supraspinatus tendon, likely contusion.

Mild hyperintensity and edema also are seen in subscapularis tendon with no obvious tear, likely contusion. Mild strain of myotendinous junction of subscapularis also seen. 

Cortical irregularity with bony remodeling and mild marrow edema is seen involving superior bony glenoid labrum in the midline.

SLAP tear is seen from approx. 9 o'clock position, extending to anteroinferior quadrant up to approx. 5 o’clock position. The tear is also seen extending into the labroligamentous complex.

An interstitial tear is seen in the intracapsular segment of biceps tendon involving a length of approx. 10 mm.

Partial tear of coracohumeral ligament, superior glenohumeral ligament and glenoid attachment of middle glenohumeral ligament is seen with a possible mild sprain of glenoid attachment of inferior glenohumeral ligament. 

Mild glenohumeral joint effusion is seen with fluid extending into subscapularis recess and bicipital groove. 

There is minimal acromioclavicular joint effusion with capsular thickening. Subtle marrow edema is noted along the clavicular articular margin – possibly grade I injury/arthropathy. 

Case Discussion

SLAP tear from approx. 9 o’clock position, extending to anteroinferior quadrant up to approx. 5 o’clock position. The tear is also seen extending into labro-ligamentus complex.

Interstitial tear in the intracapsular segment of biceps tendon involving a length of approx.10 mm.

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