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Subacromial-subdeltoid bursitis with rotator cuff tears

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Pain in left shoulder

Patient Data

Age: 55 years
Gender: Female

Fluid seen in subacromial-subdeltoid bursa.

Downsloping, type I acromion process with mild acromioclavicular joint arthropathy, eburnation along articular aspects and subchondral marrow edema (more pronounced in distal clavicle) causing reduced subacromial space.

Supraspinatus tendinosis is seen with small partial thickness articular surface tear of anterior, mid fibers at the attachment site. It involves approx. 20% thickness, measures approx. 3.5 mm in transverse and 7 mm in anteroposterior dimension.

Subscapularis tendinosis is seen with small interstitial tears in superior, mid fibers also extending into the myotendinous junction.

Mild infraspinatus tendinosis is also seen with no obvious tear.

Glenoid labrum is unremarkable. 

Hypointense sclerotic lesion is seen in proximal shaft of humerus – likely bone island (likely incidental finding).

 

Case Discussion

Fluid seen in subacromial-subdeltoid bursa consistent with bursitis.

Downsloping, type I acromion process with mild acromioclavicular joint arthropathy, eburnation along articular aspects and subchondral marrow edema (more pronounced in distal clavicle) causing reduced subacromial space.

Supraspinatus tendinosis with small partial thickness articular surface tear of anterior, mid fibers at the attachment site.

Subscapularis tendinosis with small interstitial tears in superior, mid fibers also extending into the myotendinous junction.

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