[image: 37F 1wk shoulder pain.jpg]
Arrow points to subcortical cystlike / or erosive change deep to the
supraspinatus insertion…which is virtually diagnostic for tendinosis,
with or without tear
[image: 37F 1wk shoulder pain (1).jpg]
Often we don’t have comparison XRs. On MRI, I’m finding it difficult to
know if the bright PDFS signal is in bone, deep to the insertion, or if its
a partial intrasubstance tear. I THINK the XR favors it to be osseous
change with tendinosis but not tear…but it is difficult, I think.
[image: 37F 1wk shoulder pain (2).jpg]
[image: 37F 1wk shoulder pain (3).jpg]
Maybe the Obl Ax (BLO) images are more convincing that the changes are in
bone, deep to the tendon insertion…rather than tear?
[image: 37F 1wk shoulder pain (4).jpg]
What do you think?
Would you report tear?
If you didn’t have the XR would you report tear?
Does the XR change how you report this?
Hilary
PS I see the SLAP lesion, please I don’t need you to tell me there is a
SLAP lesion
37F-1wk-shoulder-pain.pptx