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The patient has PSCl (posterior superior glenoid impingement). (Right) Sagittal FS PD FSE MR shows tendinopathy (arrow) predominantly affecting the posterior cuff tendon. 1 ROTATOR CUFF PARTIAL THICKNESS TEAR Coronal graphic shows a partial undersurface tear of the supraspinatus tendon involving the critical zone. Coronal FS PD FSE M R shows an articular surface partial tear (arrow) of the supraspinatus involving the critical zone. o Abbreviations and Synonyms +/- Anatomically sealed (closed) in the adducted shoulder imaging position Radiographic Findings Partial rotator cuff tear (PRTC Tear) Radiography o Findings associated with impingement Acromial spurs Type I11 (hooked) acromion Humeral head (HH) arthritic changes of greater tuberosity Acromioclavicular (AC) degenerative changes Definitions Incomplete (partial) tear of tendon of rotator cuff o Supraspinatus tendon most common o Three types Bursa1 surface Interstitial (within substance noncommunicating) Articular surface MR Findings General Features Best diagnostic clue o Incomplete tear or gap in the RTC tendon filled with joint bursal fluid, +/- granulation tissue o FS PD FSE or T2WI Location: Supraspinatus (SST) bursal or articular surfaces or within tendon Size: Varies from fraying to large dissecting partial tear Morphology o Irregularity (fraying) to flap morphology TlWI o Thickening of RTC tendons, of intermediate signal intensity o Calcifications in the supraspinatus, infraspinatus or teres minor = calcific tendinitis o Hypointense bone impaction (Hill-Sachs) - anterior dislocation Rotator cuff strain associated o Marrow containing acromial spur (marrow fat) T2WI o Fluid signal intensity filling an incomplete gap in the tendon FS PD FSE Gap - articular surface or bursal surface Interstitial, noncommunicating gap o +/- Fluid within the subacromial bursa EH DDx: Rotator Cuff Partial Thickness Tear Ca++ Tendinitis Cor FS PD FSE Cor Tl Arthro.
Arthroscopy 8:488-97, 1992 Nobuhara-K et al: The rotator interval lesion. Clin-Orthop (223):44-50, 1987 ROTATOR INTERVAL TEARS 2 (Ltft) Sagittal T2 FSE MR shows a hyperintense tear (arrow) of the rotator interval anteriorly. (Right) Sagittal FS PD FSE MR shows a tear (arrow) of the anterior aspect of the supraspinatus tendon extending to involve the rotator interval. (Left) Coronal FS PD FSE MR shows a tear of the rotator interval with exposure of the biceps tendon (open arrow). There is surrounding bursitis and a tear of the subscapularis tendon (arrow).
Radiology 193(2):431-6,1994 1 I INTERNAL IMPINCEMENT, SHOUl ( k p ) Coronal graphic demonstrates tearing of the infraspinatus tendon which can be seen with posterosuperior impingement. This undersurface cuff tear usually involves the anterior articular surface of the infraspinatus. (Right) Coronal STIR MR demonstrates a tear (arrow) of the infraspinatus/posterior supraspinatus in a patient with posterosuperior glenoid impingement. (Left) Clinical photograph of a baseball pitcher demonstrates posterior contracture and inability to raise throwing hand - R hand (arrow) symmetrically with the left hand.