Diagnostic ultrasound ( PDFDrive )

890 PART III Small Parts, Carotid Artery, and Peripheral Vessel Sonography
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FIG. 24.19 Partial-Thickness Tears of the Rotator Cuff. (A) Bursal-sided tear—long-axis image. A focal hypoechoic area (arrow) is shown
extending from the bursal surface of the supraspinatus tendon. (B) Bursal-sided tear—short-axis image. A focal hypoechoic area (arrow) is shown
extending from the bursal surface of the supraspinatus tendon. (C) Articular-sided tear—a focal hypoechoic tear (arrow) is present along the
articular side of the supraspinatus, shown here in long axis. (D) Articular-sided tear—a focal hypoechoic tear (arrow) is present along the articular
side of the supraspinatus, seen here in short axis. Note the long head biceps tendon (LHBT) (arrowhead) anteriorly. (E) Intrasubstance tear—long-axis
image of supraspinatus tendon demonstrates linear hypoechoic cleft (arrowhead) within the tendon, extending to the greater tuberosity (*) but not
extending to either the bursal or articular surface of the tendon. (F) Rim-rent tear—long-axis image of the supraspinatus tendon demonstrates a
hypoechoic tear (arrowhead) along the articular side of the tendon, at the insertional footplate on the greater tuberosity (*).
on ultrasound is highly associated with shoulder pain. 81 he
most common cause for luid distention of the bursa is an
underlying rotator cuf tear, which may cause communication
with the normally separate glenohumeral joint space. Uncommonly,
luid can also track through the adjacent acromioclavicular
joint in this setting and into the sot tissues supericial to the
acromioclavicular joint to form a ganglion (“geyser sign”) (Fig.
24.24). In this case, patients will have a lump over the acromioclavicular
joint, and they oten do not relate it to background
shoulder pain or immobility. Complete examination of the
shoulder is indicated in such cases to evaluate for underlying
communicating full-thickness rotator cuf tear. his is important