Wk 2, Case 5 - Review

Patient History
33-year-old man with right infraspinatus muscle atrophy.

Findings
ROTATOR CUFF:

Supraspinatus: Intact

Infraspinatus: Intact.

Subscapularis: Intact.

Teres minor: Intact.

Biceps tendon and anchor: Intact.

ACROMIOCLAVICULAR JOINT: Nominal capsulosynovial hypertrophy. Coracoclavicular ligaments intact.

SUBACROMIAL ARCH/OUTLET: Normal positioning of the acromion. Intact coracoacromial ligament. No evidence of lateral outlet stenosis or impingement.

SUBACROMIAL/SUBDELTOID BURSA: Unremarkable.

GLENOHUMERAL JOINT: No high-grade chondromalacia of the glenohumeral articular surfaces.

GLENOID LABRUM: Superior labral tear with posterior extension (SLAP 2C tear). Associated large paralabral cyst extending from the suprascapular notch into the spinoglenoid notch, measuring 3.7 x 2.4 x 1.1 cm. The majority of the bulk of the cyst resides within the spinoglenoid notch, at the likely point of entrapment.

BONES: No acute fracture or evidence of glenohumeral dislocation injury. The humeral head is centered within the glenoid. No reactive osteoedema. No aggressive osseous abnormality.

MUSCLES: Diffuse muscle edema throughout the inferior half of the infraspinatus muscle, consistent with denervation related edema (related to suprascapular nerve entrapment within the inferior aspect of the spinoglenoid notch).

Mild infraspinatus atrophy. No fatty infiltration.

Supraspinatus muscle belly preserved.

Otherwise unremarkable rotator cuff musculature, deltoid, trapezius, pectoralis minor and partially imaged isthmus dorsi.

JOINT EFFUSION: None.

INTRA-ARTICULAR BODIES: None.

SOFT TISSUE: Unremarkable.

AXILLA: Unremarkable.

Impressions
Superior labral tear with posterior extension (SLAP 2C).
Large paralabral cyst extending into the suprascapular notch and spinoglenoid notch, producing denervation edema of the infraspinatus muscle (indicating spinoglenoid notch as site of entrapment).