Hi Alexander,
We certainly do see scar tissue (granulation tissue) within the supraspinatus tendon as a result of a partial tear or partial tear with some delimitation component. The key features of such scar tissue is that it is echogenic on ultrasound and often linear in nature. The echogenic tissue will track back to the SST enthesis at the greater tuberosity and at this point there will be a small sub-periosteal cyst present from the traction injury. The echogenic area will not shadow. The echogenic area will be present in both long and short axis planes.
These areas of granulation tissue represent an old tear which has undergone a scar formation process.
It is important not to make a false diagnosis of calcific tendinosis as this is a completely different process of hydroxyapatite deposition which is often very painful.
These scar tissue areas are rarely symptomatic and are rarely associated with either joint or bursa fluid as the injury is some time ago.
They are common.
Steve.
