Only for understanding of the problems in the differential diagnostics of rupture we would like to show a quite atypical case. A patient (40) with 4 months lasting acute, initially severe pains localized about 10 cm under the shoulder joint in the area of the m. deltoideus. Pains formed at rest, at night, during sleeping. A painful flexion in the shoulder joint. At the orthopedic department a calcification of the rotator cuff was found during the X-ray examination, and the affection was classified as calcified tendonitis. 5 times a pretentious injection of Kenalog was applied, but there was not any effect. The patient was ordered for an operation of the shoulder joint – acromionectomy. At the ultrasound examination an undoubted rupture of a superficial fascia of m. deltoideus in the place where the patient felt a maximum of palpable soresness .
In our opinion, the rupture of the superficial fascia of m. deltoideus is clear at the first sight.
picture and scheme of the rupture of the fascia of m. deltoideus
This case showed a possibility of spontaneous ruptures also at younger people. The patient only remembered an enhancing physical activity when she was digging in the garden for two days before the forming of the rupture. The calcification in the area of the rotator cuff is without any relation with present affection.