Supraspinatus Tendinosis With Rim Rent Tear
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Findings
Areas of altered signal intensity are seen in the in the supraspinatus tendon in the region of the critical zone and insertion. These are hyperintense on T1/T2/FS PD images. The tendon appears bulky. This is likely to suggest tendinosis. There is an associated bursal surface tear involving almost 80% of the depth of supraspinatus. Another articular surface partial tear of the critical zone is seen involving the anterior fibers of supraspinatus tendon.
Similar signal intensity and morphological changes are noted in the subscapularis tendon near it's insertion.
The rest of the tendons of rotator cuff including infraspinatus and teres minor are essentially normal in size and signal intensity. No evidence of tear.
Mild fluid is seen surrounding the biceps tendon which maintains it's normal position in the bicipital groove. This is suggestive of tenosynovitis.
Full thickness tear of the superior labrum and biceps anchor from the underlying superior glenoid is seen. No retraction of the torn tendon seen. The rest of the glenoid labrum is normal.
A few sub-centimeter cysts are seen in the greater tuberosity of humerus, likely degenerative.
Mild collection in the superior and lateral aspect of the subacromial and subdeltoid bursa, this is indicative of bursitis. It is seen as hyper intense on T2W and FS PD images.
The acromion process reveals hooked appearance with type III appearance. The acromioclavicular joint shows mild effusion, synovial hypertrophy and changes of arthropathy with joint space reduction.
The glenohumeral joint shows normal appearance. The articular cartilage is well maintained. No evidence of recent or old fracture is noted.
The neurovascular bundles appear unremarkable.
No atrophy of the muscles around shoulder is seen.
Similar signal intensity and morphological changes are noted in the subscapularis tendon near it's insertion.
The rest of the tendons of rotator cuff including infraspinatus and teres minor are essentially normal in size and signal intensity. No evidence of tear.
Mild fluid is seen surrounding the biceps tendon which maintains it's normal position in the bicipital groove. This is suggestive of tenosynovitis.
Full thickness tear of the superior labrum and biceps anchor from the underlying superior glenoid is seen. No retraction of the torn tendon seen. The rest of the glenoid labrum is normal.
A few sub-centimeter cysts are seen in the greater tuberosity of humerus, likely degenerative.
Mild collection in the superior and lateral aspect of the subacromial and subdeltoid bursa, this is indicative of bursitis. It is seen as hyper intense on T2W and FS PD images.
The acromion process reveals hooked appearance with type III appearance. The acromioclavicular joint shows mild effusion, synovial hypertrophy and changes of arthropathy with joint space reduction.
The glenohumeral joint shows normal appearance. The articular cartilage is well maintained. No evidence of recent or old fracture is noted.
The neurovascular bundles appear unremarkable.
No atrophy of the muscles around shoulder is seen.
Diagnosis
? Supraspinatus tendinosis with rim rent tear involving articular surface of it's anterior and middle fibers.
? Subscapularis tendinosis.
? Degenerative cysts at the greater tuberosity of humerus.
? Mild collection in the subacromiodeltoid bursa.
? Biceps tendinosis with superior labrum antero-posterior tear.
? Acromioclavicular joint arthropathy causing mild impingement of supraspinatus tendon.
? Subscapularis tendinosis.
? Degenerative cysts at the greater tuberosity of humerus.
? Mild collection in the subacromiodeltoid bursa.
? Biceps tendinosis with superior labrum antero-posterior tear.
? Acromioclavicular joint arthropathy causing mild impingement of supraspinatus tendon.
Dr. Varun Gupta FRCR , MD , DNB is a Consultant Radiologist from with experience of 3-5 years post-graduated from MUHS Nashik. Specialized in Reporting of X-RAYS , CT-SCAN , MRI , MAMMOGRAM cases with expertise in Neuro-imaging , Spine-imaging , Musculoskeletal , Pediatrics-imaging , Trauma , Stroke-imaging , Cardiac
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