Clinical presentation
35 year old gentleman with history of forceful retraction of left shoulder as he stood to open the door from one side and somebody pushed to open it from the other side. Pain and restriction of movements following the episode.
MRI
Findings
Linear fluid signal intensity 13mm long 10mm wide is seen involving the interstitial fibres of anterior third supraspinatus tendon. Interstitial fluid signal intensity is also seen in the superior tendinous fibres of subscapularis tendon. intermediate signal intensity is seen in few of the fibres of infraspinatus tendinopathy.
Discussion
Characterizing size, site and length of tear is important to quantify the extent of injury and to decided conservative vs surgical management. Fluid signal intensity within a tendon confirms disruption of fibres, called as interstitial tears. It may extend to either the bursal or articular surface. Documentation of tendon retraction is important.
Read more
- Radiopaedia – rotator cuff tear
- Morag, Yoav, et al. “MR Imaging of Rotator Cuff Injury: What the Clinician Needs to Know 1.” Radiographics 26.4 (2006): 1045-1065.