Supraspinatus tear due to impingement from a sub-acromial spur

Case contributed by Dr Andrew Lawson

Presentation

Work-up for supraspinatus repair.

Patient Data

Age: 70
Gender: Female

Degenerative changes of the acromioclavicular joint with resultant subchondral cyst formation along the articular margin of the acromion. Subacromial spur localises to the region of concavity in the bursal surface of the supraspinatous tendon consistent with a partial-thickness tear.

An intrasubstance tear component continues distally in the anterior supraspinatous tendon to reach the foot plate, with possible tiny linear focus of extension to articular surface. Total partial thickness tear dimensions are approximately 17 x 28 mm. No tendon retraction. Supraspinatous tendon is thickened with hyper intense heterogeneous signal consistent with tendinosis. Minimal signal in the subacromial subdeltoid bursa. The infraspinatus and teres minor tendons are intact. The subscapularis and long head of biceps tendons are intact. No discrete labral tear. Tiny subchondral cyst noted in the anterosuperior glenoid rim consistent with degenerative changes. There is mild glenohumeral joint chondropathy.

Comment Signs of impingement, with subacromial spur that is geographically related to a chronic supraspinatus tear in the background of supraspinatus tendinopathy. The tear predominantly involves the bursal surface, with an intrasubstance component extending through the anterior portion of the tendon to the footplate, and a possible small linear component extending to articular surface.

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Case Information

rID: 27230
Case created: 24th Jan 2014
Last edited: 1st Oct 2015
Inclusion in quiz mode: Included

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