Subscapularis tear, the hidden lesion

Case contributed by Dr Andrew Lawson

Presentation

left Shoulder pain

Patient Data

Age: 70
Gender: Male

The biceps tendon is markedly attenuated and subluxed medially into the superior fibres of subscapularis which themselves demonstrate marked thickening and interstitial high signal consistent with a high-grade partial -thickness tear. There is associated prominent fatty atrophy of the subscapularis muscle belly. The supraspinatus tendon is attenuated with a high-grade partial articular surface tear of the anterior half and a focal full-thickness tear through the posterior fibres measuring approximately 8 mm. Moderate fatty atrophy. The infraspinatus tendon demonstrates tendinosis of the level of the footplate.

Case Discussion

Comment:  Partial-thickness articular surface tear of the anterior fibres with a small focal full-thickness tear of the posterior fibres of supraspinatous. Moderate fatty atrophy of the supraspinatus muscle belly. Medial subluxation of a severely attenuated biceps tendon with associated high-grade partial thickness tear of subscapularis

When biceps subluxes medially, look for the SubScap tear that can be overlooked. Called a hidden lesion.

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Case information

rID: 25297
Case created: 18th Oct 2013
Last edited: 1st Oct 2015
Inclusion in quiz mode: Included

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