Wk 4, Case 5 - Review

Patient History
51 year-old male with pain and decreased range of motion for 3 weeks.

Findings
ROTATOR CUFF: Full-thickness 9.5 x 11 mm anterodistal supraspinatus tendon avulsion, nonretracted. Mild underlying marrow reaction within the greater tuberosity of the humerus. No avulsion fracture. Interstitial longitudinal microtearing of the infraspinatus, without retracted tear. Normal teres minor tendon.

SUBACROMIAL/SUBDELTOID BURSA: Mild subacromial-subdeltoid peritendinitis.

MUSCLES (ROTATOR CUFF/DELTOID, TRAPEZIUS, PECTORALIS): Mild fibrofatty replacement of the supraspinatus at the myotendinous junction, no volume loss. The remaining rotator cuff muscular components are normal.

BICEPS TENDON: Intact biceps long head tendon without dislocation, subluxation or tear.

AC JOINT: Mild acromioclavicular arthropathy and periarticular marrow reaction, without joint separation or medial arch stenosis.

CORACOCLAVICULAR LIGAMENTS: Normal coracoclavicular ligaments.

SUBACROMIAL ARCH/OUTLET: Convex undersurface posterolaterally tilted type 2 acromion, coracoacromial ligament thickening, contributing to mild lateral arch stenosis and outlet-related cuff impingement.

SUBCORACOID ARCH: No subcoracoid stenosis.

GLENOHUMERAL JOINT: Mild nonadhesive glenohumeral capsulitis. No capsular thickening. Mild posterosuperior labral fraying, SLAP 1, no full-thickness labral tear or paralabral cyst.

GLENOID LABRUM: SLAP 1 posterosuperior labral fraying.

BONES: No macrofracture.

SUBCUTANEOUS SOFT TISSUES: Normal without mass.

AXILLA: No lymphadenopathy.

Impressions
Full-thickness footprint avulsion tear, mostly horizontal, nonretracted, 9.5 x 11 mm; mild bony marrow reaction in the underlying greater tuberosity, no fracture. Early fibrofatty infiltration of the supraspinatus at the myotendinous junction.
Mild active acromioclavicular arthropathy.
Mild tendinopathy of the subscapularis, with interstitial microtearing at the footprint, no macrotear or retraction.
Nonadhesive glenohumeral capsulitis. Mild labral fraying.