J Korean Soc Radiol.  2010 Sep;63(3):271-274. 10.3348/jksr.2010.63.3.271.

Fluid Signal Intensity That Mimicked A Supraspinatus Tendon Tear In A Subacromial Injected Shoulder: A Case Report

• Kim TH
• Kim TE
• Shin HW

• KMID: 2097905
• DOI: http://doi.org/10.3348/jksr.2010.63.3.271

Abstract

Subacromial steroid injections are a common procedure for treating shoulder pain. Several studies have reported on the difficulty of performing an accurate injection into the subacromial bursa, as well as the injected material infiltrated into other regional structures even when an accurate injection was done into the subacromial space. These misplacements, and especially in the rotator cuff, creates high signal intensity on T2WI that can mimic a rotator cuff tear. Bergman and Fredericson found that the bursal and extrabursal fluid is resolved or decreased 3 days after the injection, so they recommended a 3-day delay after the shoulder injection before performing MRI to prevent misinterpretation of the signal changes. We report here on a case of a false full-thickness tear of the supraspinatus tendon on MRI one month after subacromial injection, and the supraspinatus tendon turned out to be intact on the follow up ultrasonography and arthroscopic examination.

MeSH Terms

Follow-Up Studies
Hydrazines
Magnetic Resonance Imaging
Rotator Cuff
Shoulder
Shoulder Pain
Tendons
Hydrazines

Figure

• 

  Fig. 1 A. The oblique coronal fat-saturated T2-weighted image shows fluid signal intensity (white arrow), suggesting a tendon tear in the supraspinatus tendon. B. The axial fat-saturated T2-weighted image shows fluid signal intensity (white arrow), suggesting a tendon tear in the supraspinatus tendon. C. The supraspinatus tendon is intact on arthroscopy. (SST: Supraspinatus tendon, IST: Infraspinatus tendon, GT: Greater tuberosity) D. The short-axis 15 MHz US image shows an intact supraspinatus tendon without a definite focal fluid collection. (Deltoid: Deltoid muscle, SupraS: Supraspinatus tendon, HH: Humeral head)

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