Patient has a painful shoulder after a mountain biking accident. X-Ray findings were negative (not done by me). On ultrasound a fracture through the base of the greater tuberosity is noted, in good position. Note the small defect at the attachment of the supraspinatus tendon in the region of the proximal aspect of the fracture.
Patient is a 40 year old male who lifted a heavy object and experienced a sudden tearing pain in the shoulder. Note the torn transverse humeral ligament with a medially dislocated long head of the biceps tendon. The rotator cuff is intact.
A partial thickness tear is noted of the articulating surface of the infraspinatus tendon. Of note is the bone pitting of the bony surface of the greater tuberosity. When this is seen on ultrasound, an adjacent tear must always be suspected. The subdeltoid portion of the tendon is still intact and no fluid was seen in the subdeltoid bursa.
An acute, full thickness tear is noted of the “critical zone” of the supraspinatus tendon with fluid noted in the subdeltoid bursa.
Patient has pain in the right shoulder. There is a typical lamellar small intra-substance tear of the supraspinatus tendon.