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Impingement syndrome with supraspinatus tendinopathy and atrophy

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis certain

Presentation

Chronic right shoulder pain and weakness.

Patient Data

Age: 45 years
Gender: Male

The right acromioclavicular joint shows hypertrophic osteoarthropathy that assumes a callus-like appearance. Consequent compression of the underlying paratendinous fat planes and the related passing part of the supraspinatus tendon. The muscle bulk of supraspinatus is remarkably diminished with diffuse fatty infiltration. The distal part of the supraspinatus tendon till its insertion shows intermediate signal on T1, PD and T2 WIs with diffuse relative thickening. No definite tendon discontinuity or gap. Excess fluid in the subacromial bursa.

Case Discussion

Typical case of impingement with the serious consequence of supraspinatus muscle atrophy evident by the tangent sign as seen on the sagittal oblique sequences.

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