Presentation
Work-up for supraspinatus repair.
Patient Data
Degenerative changes of the acromioclavicular joint with resultant subchondral cyst formation along the articular margin of the acromion. Subacromial spur localizes to the region of concavity in the bursal surface of the supraspinatus tendon consistent with a partial-thickness tear.
An intrasubstance tear component continues distally in the anterior supraspinatus tendon to reach the footplate, with the possible tiny linear focus of extension to the articular surface. Total partial thickness tear dimensions are approximately 17 x 28 mm. No tendon retraction. Supraspinatus 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.
Case Discussion
Signs of impingement, with a 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 the articular surface.
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