Rotator Cuff

[Michael Shilton]

Dear Stephen, what do you make of this 27 yr old male who fell skiing 6 weeks ago and since then is only able to abduct to 60 degrees. He has weak supraspinatus and infraspinatus. I’m thinking SSP full thickness, partial width tear with significant cortical disruption and sub periosteal cyst formation. Is there fracture? Avulsion? Regards, Mike

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[Stephen Bird]

Hi Mike,

Easy one for me for a change,

This is a significant orthopaedic fracture of the greater tuberosity,

organise some plain radiographs and he may benefit from a CT or MRI cross sectional assessment.

It is certainly a fracture.

Steve

[Michael Shilton]

Hi Stephen, that’s great, he had an x ray 3 weeks ago which he reports as no fracture. A tick in the box for ultrasound, many thanks, Mike

[Stephen Bird]

If they repeat the x-ray now its will be obvious. Undisplaced greater tuberosity fractures can be subtle, but 3 weeks after the trauma it will be easy to see.
Indeed ultrasound can be great for discovering undisplayed acute fractures,

Great work by you Mike,

Nice scanning,

Steve

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