Parcial Rupture of M. Supraspinatus

A patient  (73) comes because of the pains of the right shoulder which formed spontaneously, without any evoking factor. Pains are extreme, the patient cannot sleep at night, and she cannot lie on the affected side. The motility is restricted because of pains, and we cannot examine her. Haematoma occurred after 3 days of problems in the area of the attachment of the deltoid muscle.

Ultrasound Finding  

holrupX.jpg (62760 bytes)

picture and scheme of a  parcial rupture of the rotator cuff

 

videosequence of a parcial rupture of the rotator cuff (longitudinal section) holf.avi

holfbX.jpg (56248 bytes)

Picture and scheme of tenovaginitis of the long head of the biceps at the rupture of the rotator cuff at the same patient (transversal section)

 

holaXX.jpg (70702 bytes)

Picture and scheme of an articular hydrops at the parcial rupture of the rotator cuff in the axillary section (signs of articular hydrops  - see pathological distance 5,8 mm of the articular capsule from the head of the humerus)

Conclusion

A parcial rupture of the rotator cuff with a development of the articular hydrops and tenovaginitis of the long head of the biceps.

Commentary

Also at this patient a combination of several pathologic states was found, i.e. a rupture of the attached part of the rotator cuff, a liquid in the glenohumeral joint (vs. haematoma, partial and reactive synovitis), tenovaginitis of the long head of the biceps. Simultaneously a clinical importance of parcial ruptures of the rotator cuff was confirmed. An existence of spontaneous ruptures, which are quite frequent, in our opinion, (mainly at older age) was demonstrated again. Because an orthopedists did not recommend an operative solution, so we only aspirated the liquid from the joint and the long head of the biceps, and we applied steroids into these localization with a good effect.