SLAP tear and supraspinatus full-thickness tear

Case contributed by Dr Yair Glick


Pain and decreased range of motion (ROM), history of trauma

Patient Data

Age: 50 years
Gender: Male

Shoulder MR arthrography


Rotator cuff:
Full-thickness supraspinatus tendon tear 15 mm wide at its distal anterior part, adjacent to its insertion. No retraction [held in place by a few fibers], with free passage of the contrast material into the subacromial-subdeltoid bursa.
Infraspinatus, subscapularis, and teres minor tendons are of normal thickness, integrity and signal. Muscles are of normal thickness, without signs of atrophy or fatty infiltration.
Long head of biceps (LHB) is of normal thckness and signal, in normal location in bicipital groove.
Glenoid and labrum: A labral tear extends anteriorly to 2 o'clock and posteriorly to 9 o'clock. No apparent fracture of the glenoid. No signs of damage or erosion to the hyaline cartilage.
Humeral head: No pathological findings.
Acromioclavicular joint: No pathological findings.

In summary:
1. Full-thickness SSP tear;
2. Extensive tear in the superior glenoid labrum, anteror and posterior (SLAP tear).

Case Discussion

Seeing as this patient is older than 40, the SLAP tear is probably associated with the supraspinatus tear.

Luckily for the patient, the supraspinatus tendon did non retract, as it was held in place by a "thread" of several intact fibers. This is why the supraspinatus had not undergone any fatty degeneration, which means that surgical repair is warranted.

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