Shoulder Pathology
Rotator Cuff Tears
Images of Rotator Cuff Tears
FULL THICKNESS TEAR
A: Image of a full thickness tear of the supraspinatous. This is a full thickness tear because the tear goes from the articular to bursal side of the tendon. (S = superior facet).1
A: Image of a full thickness tear of the supraspinatous. This is a full thickness tear because the tear goes from the articular to bursal side of the tendon. (S = superior facet).1
B: This image is the short axis view of the tear in image A above. The arrowhead it pointing to the cartilage interface sign, which is commonly visualized with full thickness tears.1
PARTIAL THICKNESS TEAR: ARTICULAR SIDE
A: This image is of a partial thickness tear on the articular side of the supraspinatous tendon in the long axis. The arrowheads show a cortical irregularity of the greater tuberosity, which is a characteristic finding with articular partial thickness tears.1
A: This image is of a partial thickness tear on the articular side of the supraspinatous tendon in the long axis. The arrowheads show a cortical irregularity of the greater tuberosity, which is a characteristic finding with articular partial thickness tears.1
B: Another image of a articular partial thickness tear of the supraspinatous tendon. This image is in the long axis.1
C: Short axis image of the same articular partial thickness tear from image B. In the short axis the cartilage interface sign in seen (straight arrows). The cartilage interface sign is commonly seen with articular partial thickness tears, but is not seen with bursal partial thickness tears.1
PARTIAL THICKNESS TEAR: BURSAL SIDE
This image is showing a bursal partial thickness tear of the supraspinatous tendon. Image is taken in the short axis. We can see a hypoechoic disruption of the superficial tendon fibers on the bursal side of the tendon.1
This image is showing a bursal partial thickness tear of the supraspinatous tendon. Image is taken in the short axis. We can see a hypoechoic disruption of the superficial tendon fibers on the bursal side of the tendon.1
PARTIAL THICKNESS TEAR: INTRASUBSTANCE
Short axis image of an intrasubstance partial thickness tear. Arrowhead shows a slight contact with the greater tuberosity with a cortical irregularity. Instrasubstance tears can be at the greater tuberosity or within the tendon fibers.1
Short axis image of an intrasubstance partial thickness tear. Arrowhead shows a slight contact with the greater tuberosity with a cortical irregularity. Instrasubstance tears can be at the greater tuberosity or within the tendon fibers.1
ACUTE FULL THICKNESS TEAR
Long axis image of a focal acute full thickness year of the supraspinatous tendon.1
Long axis image of a focal acute full thickness year of the supraspinatous tendon.1
CHRONIC FULL THICKNESS TEAR
A: This is a long axis image a chronic full thickness tear of the supraspinatous tendon. Shows a fluid filled disputation of the tendon fibers. This is a full thickness tear because it extends from the articular surface to the bursal surface of the tendon. The arrowheads point to the cartilage interface sign. 1
A: This is a long axis image a chronic full thickness tear of the supraspinatous tendon. Shows a fluid filled disputation of the tendon fibers. This is a full thickness tear because it extends from the articular surface to the bursal surface of the tendon. The arrowheads point to the cartilage interface sign. 1
B: Another long axis image of a chronic full thickness tear. This tear is nearly a complete tear because of the recession of the tendon (where the asterisk is on the image). Loss of normal superior convexity is seen. The distal tear is filled with isoechoic synovitis (curved arrows).1
Miscellaneous Shoulder Pathology
Images of Miscellaneous Shoulder Pathology
BURSITIS
This is an image of a subacromial bursitis. In this image we see anechoic fluid in the subacromial bursa (where the arrow is pointing too). 1
This is an image of a subacromial bursitis. In this image we see anechoic fluid in the subacromial bursa (where the arrow is pointing too). 1
CALCIFIC TENDONITIS
This is an image of the supraspinatous tendon. The arrow is pointing to a well-defined linear calcific deposit along the supraspinatous tendon fibers. 1
This is an image of the supraspinatous tendon. The arrow is pointing to a well-defined linear calcific deposit along the supraspinatous tendon fibers. 1
ARTHRITIS
Erosions on the humeral head in a patient with rheumatoid arthritis. 3
Erosions on the humeral head in a patient with rheumatoid arthritis. 3
ADHESIVE CAPSULITIS
A: This image is showing the supraspinatous tendon with the patients arm in the neautral position. 1
A: This image is showing the supraspinatous tendon with the patients arm in the neautral position. 1
B: This image shows that the supraspinatous tendon (labelled S) does not slide beneath the acromion (labelled A), as it should with arm elevation.1
References:
1. Jacobson, J.A. (2013). Fundamentals of Musculoskeletal Ultrasound: Second Edition. Elsevier Saunders: Philadelphia, PA.
2. Nuffield Orthopaedic Centre & Oxford Radcliffe Hospital. (2003). Imaging the Shoulder. Imaging. Retrieved from http://imaging.birjournals.org/content/15/4/162/F11.expansion.html
3. Geertsma, T. (n.d.). Musculoskeletal Joints and Tendons: Case 6.1.20 Shoulder Arthritis. Ultrasound Cases Info. Retrieved from http://www.ultrasoundcases.info/Slide-View.aspx?cat=328&case=6295
1. Jacobson, J.A. (2013). Fundamentals of Musculoskeletal Ultrasound: Second Edition. Elsevier Saunders: Philadelphia, PA.
2. Nuffield Orthopaedic Centre & Oxford Radcliffe Hospital. (2003). Imaging the Shoulder. Imaging. Retrieved from http://imaging.birjournals.org/content/15/4/162/F11.expansion.html
3. Geertsma, T. (n.d.). Musculoskeletal Joints and Tendons: Case 6.1.20 Shoulder Arthritis. Ultrasound Cases Info. Retrieved from http://www.ultrasoundcases.info/Slide-View.aspx?cat=328&case=6295