Diagnostic ultrasound ( PDFDrive )

CHAPTER 24 The Shoulder 887
A
B
C
FIG. 24.14 Focal Full-Thickness Supraspinatus Tear. (A)
Long-axis image of the anterior supraspinatus tendon demonstrates
intact ibers (arrowheads). (B) Long-axis image of more posterior
ibers of supraspinatus show a full-thickness tear with hypoechoic
luid (arrow) within the gap between the torn tendon end (arrowheads)
and the greater tuberosity (*). (C) Short-axis image of supraspinatus.
Intact anterior ibers (white arrowhead) are shown, with a luid-illed
gap (straight arrow) at the posterior supraspinatus tear. Intact anterior
infraspinatus ibers (curved arrow) are visible posterior to the tear.
Assisting in orientation, the long head biceps tendon (black arrowhead)
appears anteriorly.
A
B
FIG. 24.15 Full-Thickness Supraspinatus Tear With Retraction of the Tendon Beneath the Acromion. Image in the expected location of
the supraspinatus tendon in long (A) and short (B) axis demonstrates absence of the tendon above the humeral head (*) and greater tuberosity
(white arrow). Fluid and debris are seen in place of the normal tendon (arrowheads). Note the intact long head biceps tendon anteriorly (black
arrow).
noncompressible, complex echogenic debris and granulation
tissue that are contiguous with the subacromial subdeltoid bursa,
and this may give the false impression of rotator cuf volume to
the novice practitioner.
Partial-Thickness Rotator Cuff Tears
As with full-thickness rotator cuf tears, partial-thickness
tears occur in both younger and older patients. Partial tears
occur more commonly than full-thickness tears in younger
patients, and most commonly occur in young athletes.
Partial articular-sided supraspinatus tears are the most
common subtype in the young athlete. 66 In the older patient
population, partial-thickness tears also most commonly
occur in the supraspinatus tendon, but the most common
cause is tendon degeneration, with increased incidence as
patients age.