Findings

There is a complete tear of the supraspinatus tendon, leaving a large gap at the surface of the humeral head. In a normal view, the supraspinatus tendon spans across the surface of the humeral head.

Impression

Rotator Cuff Tear, Right Shoulder

Clinical Pathologic Correlation
Rotator cuff tears occur with acute injury as well as age-related degeneration, chronic mechanical impingement, and altered blood supply to the tendons. They often originate in the supraspinatus tendon. Full thickness tears such as the one shown are uncommon in those <40 years old. Patients often complain of recurrent shoulder pain, especially at night or when sleeping on the affected side, as well as weakness lasting several months; there may be a specific injury that triggered the pain. On physical exam, active range of motion is limited. Treatment recommendations include pharmacotherapy, physical therapy, and possibly injection for pain. Failure of 6 weeks non-surgical treatment is an indication to seek further evaluation and consider surgical intervention.

View

MRI (magnetic resonance image)

Specimen

Right Shoulder

Image Credit

Douglas Chang, M.D., Ph.D.
Department of Orthopedic Surgery
School of Medicine
University of California, San Diego