Weekly Case

Title : Case 639

Age / Sex : 56 / M


Chief complaint : Lt. shoulder pain after bicycle accident, 2-month ago

What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy : Hye Jung Choo, 
Inje University Busan Paik Hospital


 



Discussion


Answer:  Novel lesion of infraspinatus (myotendinous junctional tear of infraspinatus tendon)


 


Findings: Isolated increased signal intensity at the infraspinatus muscle with discontinuity of the myotendinous junction of the oblique head of infraspinatus tendon and partial tear of the long head of biceps brachii tendon and subscarpularis tendon


 


Differential Diagnosis:


 


Discussion: Novel lesion of infraspinatus



  • Tear at or adjacent to MT – not tendon insertion

  • Edema of the infraspinatus muscle in the initial phase

  • Prominent muscle atrophy & fatty degeneration over time

  • Indirect trauma (muscle contracture, resistance…)

  • Women > Men

  • 49 years (younger than isolated injury of SST)

  • Common in patients with local cortisol injection/needling

  • Difficult to detect on arthroscopy, even if lesion is prospectively identified on MRI


References:


Isolated lesion of the infraspinatus at the myotendinous junction: a new lesion) J Radiol 2006;87:1875-82


A novel lesion of the infraspinatus characterized by musculotendinous disruption, edema, and late fatty infiltration J Shoulder Elbow Surg 2008;17:546-553


 


 


 


To submit your answer, login first (for Korean radiologists) or send e-mail to balgundol@gmail.com (for non-Korean radiologists)

Correct Answer
Total applicants 23 Correct answers 3
Name Institution
김기욱 국군수도병원, 전문의
박병진 국군강릉병원, 전문의
김성진 365병원, 전문의
Semi-Correct Answer
Total applicants 23 Semi-Correct answers 10
윤유성 순천향대 부천병원, 전문의
최형인 군의관, 전문의
전인환 전문의
김지은 서울대학교병원, 전문의
강지희 서울대학교병원, 전문의
장성원 중앙보훈병원, 전공의
이규정 고대안암병원, 전문의
백승진 분당차병원, 전공의
김상희 전공의
정치형 단국대학교병원, 전공의


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