Tear or area between tendon bundles

[Diane]

Hi Steve,

I’ve attached some images of a shoulder I recently scanned where I was querying a bursal sided partial thickness tear. Any opinions?
I was a bit iffy because was also thinking maybe it could just be the area between the tendon bundles? What are the common places where the borders of a tendon bundles may be mistaken for a tear that we should be cautious about?

Thanks

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[Stephen Bird]

Interesting images,

In think the area you are looking at on the bursae surface is just a normal bundle of muscle rather than a bursae surface tear.

That location would be an odd place for a tear and a tear is unlikely to have that appearance.

When patients are younger or more physically active the muscle bundles to extend further into the tendon towards the enthesis.

That linear cleft seen in the short axis that passes through zone 2 of supraspinatus is a common finding and when you look long axis it looks normal.

BUT in the video that you attached I am sure there is an articular surface partial thickness tear in the mid / posterior part of the supraspinatus with associated enthesis irregularity.

Steve

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