Subscapularis and long biceps tendon rupture

Case contributed by Andrei Dumitrescu
Diagnosis certain

Presentation

Pain and decreased range of motion at the right shoulder after falling on ice a few days before.

Patient Data

Age: 55 years
Gender: Male

MR arthrography

mri
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Sagittal
PD fat sat
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Coronal PD
fat sat
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Axial PD
fat sat
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Coronal T1
fat sat
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Axial
T1
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Axial
T1
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Info

Complete rupture of the long biceps tendon proximally with marked retraction. Subtotal tear of the subscapularis tendon with rupture and retraction of most fibers near the humeral insertion site, only a small portion remains intact caudally. Non-displaced anterosuperior labral lesion (Perthes variant). The supraspinatus and infraspinatus tendons are intact. Contrast in the subacromial-subdeltoid bursa due to the rotator cuff tear. Mild degenerative changes at the AC joint.

Case Discussion

Subscapularis tendon tears are less frequent than supraspinatus and infraspinatus tears. They are often associated with long head biceps tendon tears and labral or SLAP lesions, due to the mechanism of injury frequently involving anterior dislocation of the shoulder. 

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