Traumatic subscapularis tendon tear

Case contributed by Domenico Nicoletti

Presentation

Fall during football match with hyperextension of the abducted arm. Patient report pain and weakness in the affected shoulder.

Patient Data

Age: 15 years
Gender: Male

Full thickness rupture of the subscapularis tendon with detachment of lesser tubercle attachment and obvious retraction of the subscapularis tendon. Sagittal images show a bare lesser tuberosity. The subscapularis muscle is normal.

Surgical repair of the subscapularis tendon.

Case Discussion

Isolated injury to the subscapularis tendon can occur as a result of traumatic injury or chronic degeneration. The injury ranges from small superior tears associated with biceps tendon subluxation to large tears and anterior glenohumeral instability. Tears often begin at the superior insertion where tendon fibers blend with the biceps pulley; medial subluxation of the biceps occurs with loss of this restraint. Tear progression then proceeds inferiorly leading to increasing anterior instability and weakness.

Case courtesy: Dr.ssa Laura Braccaioli

Radiographer: TSRM Fabio Imola

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