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Case of the Month

August 2018

Patient Data: Middle age female patient examined for SONOZORG a primary care ultrasound facility

Clinical Info: Shoulder pain

Abnormal supraspinatus tendon How would you describe it A tendinosis B tendinosis and partial articular sided rupture C Tendinosis and intratendinous rupture D full thickness rupture

Another longitudinal image

A third longitudinal image

A transverse image showing cortical irregularities. The patient had a partial defect in the tendon in contact with the articular cartilage. Cortical irregularities are often found in combination with tendon ruptures

This is a longitudinal image of the supraspinatus tendon of another patient. It is not always possible to determine the exact extent of a tendon rupture. There is a partial rupture and volume loss and bursal thickening.

Transverse image of the same patient

Always check if the patient has been operated! This tendon has been repaired and the bony anchors are visible

Another longitudinal image of the operated patient.This tendon also shows volume loss.

The tendon shows volume loss and the bursa is thickened. But the tendon is still intact

The first patient had some tendinosis and a partial articular sided supraspinatus tendon rupture. The rupture communicates with the articular cartilage but not with the bursa. There are also cortical irregularities
The second patient also had a supraspinatus tendon rupture with volume loss and bursal thickening but the exact extent was unclear (intratendinous or partial bursal sided) .
The third patient also showed volume loss of the tendon but was operated on the tendon which was still intact.

For more examples of partial articular sided supraspinatus tendon rupture see

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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