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Ultrasound shows a hypoechoic or anechoic defect from the articular to bursal surface of the SSC tendon.
At 90 degrees of shoulder abduction and 45 degrees of external rotation the exostosis impinged upon the bursal surface of the rotator cuff.
A full-thickness tear was diagnosed in case of a discontinuity or a gap in the tendon or increased signal intensity (isointense compared to fluid) on T2-weighted images, extending from the articular to the bursal surface of the tendon (Ianotti et al. 1991).
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A bursal - side tear produces flattening of the bursal surface, with loss of the superior convexity of the tendon, while an articular - side tear appears as a distinct hypoechoic or mixed hyper - hypoechoic defect of the articular surface, abutting the articular cartilage [ 27]. 2) Full thickness tear: full defect in the tendon from the bursal to the articular margin.
Our findings further support this prevalence and suggest tears involving the anterior portion of the supraspinatus tendon propagate from the articular surface toward the bursal surface.
Furthermore, the articular side of the supraspinatus tendon has been found to experience more strain compared to the bursal surface under uniaxial loading [ 35].
The subscapularis muscle and tendon are in intimate relationship to the anterior surface of the bursal recesses.
MRI shows a local high signal on FS T2-weighted images, without any extension to the bursal surface.
First, tears on the articular surface of the supraspinatus tendon are two to three times more frequent than bursal-sided tears [ 33, 34].
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