Lenz R, Kircher J, Schwalba K, Weber M, Tischer T. Subscapularis Tendon Tears - Usefulness of Written MRI Reports ForGuiding Patient Referral to Shoulder Specialists. By clicking Accept, you consent to the use of ALL the cookies. View publication. Why repair the subscapularis? Gentle pressure is used initially across the supraspinatus tendon until the area becomes numb, known as the analgesic effect. The most common symptom of a subscapularis tear is shoulder pain, especially in the front of the shoulder. OrthoTexas mourns the passing of Dr. Alex Glogau, Repeated arm movement that involves lifting or throwing actions, Inefficient warm ups before playing a sport, Playing a sport or training when the muscles are strained or injured, Inherent mechanical problems in the shoulder joint, Tendinitis- prolonged use of the muscles leads to degeneration, Forceful forward or backward movement of the arm, Slipping out of the biceps tendon from its grove and cutting across the subscapularis tendon, Pain in the front part of the shoulder, which may get aggravated with upper arm or body movement, Lifting, twisting and rotation of the arm may be painful, Tenderness in the affected part of the joint, The preferred mode of treatment in elderly patients is, Arthroscopic surgery may be recommended in people who are physically active. This shouldnt hurt. This will allow the tendon to heal. The purpose of the anti-inflammatory drugs is to relieve pain, so that the patient can concentrate on rebuilding the strength of the muscle. Skeletal Radiol. This article may contains scientific references. Subscapularis tendon tears. Scapula is a flat bone that lies at the back of chest wall over the ribs on right and left side. It usually develops alongside other rotator cuff muscle tears, which may be result of trauma or repeated micro-trauma. The frequency of subscapularis tears in arthroscopic rotator cuff repairs: A retrospective study comparing magnetic resonance imaging and arthroscopic findings. The ERLS exploits the fact that a muscle with a full-thickness tear has less capacity to work. Feel pain across your back? The biceps muscle attaches to bone via tendons; two at the shoulder and one in the elbow. The subscapularis connects from your shoulder blade to your humerus, or upper arm bone. A subscapularis tendon tear is a tear of the subscapularis tendon. The clinician can detect the following on examination: increased pasive external rotation, weak internal rotation, positive tests for subscapularis tears ( Bear-hug test , belly-press test , Gerber's lift-off test ). Garavaglia G, et al. The principles of subscapularis tendon repair are similar to general principles for rotator cuff tears. Subscapularis tendon tear. Symptoms of a supraspinatus tear include: Sharp pain in the shoulder at the time of injury. Supraspinatus tendonitis develops when there is repetitive friction on the tendon or it is repeatedly squashed or "impinged" in the subacromial space. You In most cases, youll regain full use of your shoulder after surgery. Tenderness in the affected part of the joint. It causes pain and restricted movement in the shoulder joint. pain that increases with shoulder use. Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet. A subscapularis tear can often be managed and fully heal without surgery. Experts say that there . SubscapularisSubscapularis is a muscle and tendon that connects the scapula to the front of the head of the humer tendon tears are a common injury, especially among athletes. Adams C, Brady P, Koo S et al. 78 Interstitial tears (Figure 6), also known as intrasubstance tears or intramuscular cysts, can occur in isolation within the tendon without articular- or bursal-sided extension, or they can also . If you don't have these symptoms, chances are it's not supraspinatus tendonitis, so check out the shoulder pain diagnosis section for help working out what is wrong. We also use third-party cookies that help us analyze and understand how you use this website. It is the large one at the front of the shoulder. This website uses cookies to improve your experience. Anterior shoulder swelling. (n.d.). Our website services, content, and products are for informational purposes only. But opting out of some of these cookies may affect your browsing experience. Clearly written and matches the guidance from my orthopedic surgeon. After that, youll start physical therapy and gradually increase your range of motion. Park SH, et al. However, with rest and physical therapy, you should regain full use of your shoulder after surgery. All rights reserved. Injury can occur to the tendon as it inserts into the top of the shoulder on the humerus. The subscapularis muscle rotates the shoulder inward (internal . Previous studies have reported subscapularis tendon tears in 2% of rotator cuff tears . With supraspinatus tendonitis, it is really important to get the right balance between resting, to give the tendon time to heal, and doing exercises to improve the strength and flexibility in the shoulder muscles. If you suspect a dislocated shoulder, seek immediate medical attention. The supraspinatus muscle runs along the top of the shoulder blade and inserts at the top of the arm, or humerus bone, and is one of the four rotator cuff muscles. Thank you!" It is a very difficult medical condition to treat. Infraspinatus Tendon Tear. Isolated subscapularis tear from minimal trauma in a recreational athlete: a case report. 14 Biceps tenodesis may be considered in serious tears or rupture. Small intestinal submucosa (SIS) has been used for reinforcement of other tissues in the body with success and has been shown to act as a bioabsorbable tissue scaffold that promotes and assists healing. Three patterns of subscapularis tendon tears have been described 1-3: supraspinatus tendon involvement or as part of a massive rotator cuff tear, 80% of subscapularis tears also have a supraspinatus tendon tear, rotator intervalextension potentially involving the superior glenohumeral ligament (SGHL)and coracohumeral ligament (CHL)and can lead to biceps instability, especially when superior tears are present, isolated: rare; most commonly traumatic in the setting of anterior glenohumeral instability. Epidemiology. shoulder or arm weakness. The material on this website is designed to support, not replace, the relationship that exists between ourselves and our patients. The space then opens back up once the arm is raised higher and externally rotated (thumb pointing up). This will help to reduce inflammation and pain. It is one of the four rotator cuff muscles. Tendinosis of the infraspinatus and subscapularis tendons. . Surgical repair can be performed open or arthroscopically without or without augmentation. This is because other muscles need to compensate for a tear in the subscapularis and can be put under a lot of stress. Typically, supraspinatus tendonitis is an overuse injury caused by repetitive friction on the tendon, but it can be caused by a shoulder injury, instability or shoulder impingement. pain that gets worse when you lift your arm. This article may contains scientific references. However, older patients may present with traumatic subscapularis tears If the rupture is partial, they will immobilize the arm and prescribe rest. Kuhn JE, Dunn WR, Sanders R, et al. Subscapularis tear includes tear of subscapularis muscle and tendon. These include: pain that gets worse at night. Subscapularis tendon or muscle tear is either partial or full thickness and injuries are confirmed with MRI studies.D Symptoms of the muscle and tendon tear are different. The surgery is done using small instruments that are also inserted through small slits. Test is performed in standing position. On the whole around 90% of people achieve satisfactory response with surgery. But surgeons are starting to see more subscapularis tears in active seniors. Check for errors and try again. A Systematic Approach for Diagnosing Subscapularis Tendon Tears with Preoperative Magnetic Resonance Imaging Scans. Increased pain and weakness when the arm is raised sideways between a 60-degree arc. Subscapularis Tear: Causes, Symptoms, Signs, Treatment, Diagnosis, Investigations, Rotator Cuff Tear: Types, Causes, Risk Factors, Symptoms, Diagnosis, Treatment, Recovery, Rehabilitation, Complications, Dietary Dos and Donts for Migraine Sufferers, Shirshasana (Headstand) Versus Inversion Therapy Using Inversion Table, Understanding Joint Pain and Tips to Get Relief Using Home Remedies, Erectile Dysfunction: Does Opioid Cause ED, Libido: Opioid Induced Female Sexual Dysfunction, Recovery Phase Post Surgery For Subscapularis Tendinitis, FAQ on Subscapularis Tendon Repair Surgery. Full Disclaimer. Its main function is to rotate the upper arm inwards. Prior studies have demonstrated equivalent outcomes between in situ tear fixation and tear completion repair techniques. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Long head of biceps tendon sheath effusion >2 mm has been associated with subscapularis tendon tears 5. Fifty-seven tears were traumatic, and twenty-seven were degenerative. Interstitial tears may represent up to 33% of partial thickness tears 77 and are thought to represent shearing forces within a degenerated tendon. 8. Old age is also a major factor in supraspinatus tears; in fact, over 50% of people over seventy years old have a supraspinatus tear when . Viktoria, "This is a great site. The mean interval from the onset of symptoms to the time of surgery was 12.5 months. The best exercises to do with supraspinatus tendonitis are: Improving your posture can also make a massive difference. These cookies ensure basic functionalities and security features of the website, anonymously. It is important to understand that he will have to wear a sling for for weeks after the surgery and that after twelve weeks after the physical therapy will concentrate on muscle strengthening. Very informative" Marilyn, "I benefited a lot (A) Coronal T2-weighted fat-suppressed MR image and (B) sagittal T2-weighted fat-suppressed MR image demonstrating an intrasubstance delaminating tear of the subscapularis tendon (white arrow) extending medially in a linear fashion, terminating as "sentinel" cysts at the myotendinous junction (yellow arrows). Pain when the arm is rotated outwards and upwards. Without rounding your back, swing the free arm back and forth. At 6 months post-operatively, the average pain score decreased from 6.2 to 1.7 in patients with articular tears and from 7.1 to 0.9 in patients with bursal tears. DOI: Rotator cuff and shoulder conditioning program. Patient will have to overcome resistance applied by examiners hand. Tears can be small or can go through most of the muscle. 2022;2022:4009829. You shouldnt have more than three shoulder injections per year. However, when it happens for the subscapularis to tear, then it is going to be extremely painful and it will also affect the tendon of the biceps, dislocating it from its normal position. You also have the option to opt-out of these cookies. Pain radiates throughout the shoulder initially. ShoulderDoc.co.uk satisfies the INTUTE criteria for quality and has been awarded 'editor's choice'. Depending on how extensive the tear was, the patient diagnosed with subscapularis tear can return to full functioning and activity in somewhere between six and twelve months. Get To Know What Possibly Could Be Causing Your Symptoms! -Intrasubstance (INTRASUBS) tear of tendon of long head of biceps muscle in 67-year-old male patient with 4 months of chronic shoulder pain. Arthroscopic repair in case of partial or full subscapularis tears the rupture site is visualized with the help of an arthroscopic camera and it is then sutured with the help of professional arthroscopic equipment. Pain is often caused by hyperextension of shoulder joint during sleep resulting in hyperextension of rotator cuff and subscapularis tendon. The size of the tear determines what treatment is needed. Sayed, "Hi The rupture site is visualized by arthroscopic camera and sutured using arthroscopic equipment. Skin incision is made over the injured tendon and tear. Symptoms. no financial relationships to ineligible companies to disclose. 2008;24(9):997 . Options may include a mastectomy, chemotherapy, radiation, or removal of skin lesions. The success of surgery is totally dependent on the quality of tendon tissue and the extent of the tear. THOMAS L. GOWEN, Special Master.. On April 30, 2018, Dee Ann Quantie ("petitioner") file a petition for compensation under the National Vaccine Injury Compensation Program. The cookie is used to store the user consent for the cookies in the category "Performance". See our. Physiotherapy is tried prior to surgery. Subscapularis tears can have intermediate or fluid-like intrasubstance tendon signal, tendon margin irregularity, tendon defect and/or tendon retraction 8. 2016;7(6):779-91. Some tears may be too old (chronic) and large for a direct repair. Surgery. There is a normal space anterosuperiorly, the rotator interval, where the cuff is perforated by the coracoid process. The red is the muscle, and the white at the ends of the muscle where the arrows point in the below illustration is the tendons. Mild to moderate inflammation of the subscapular tendon is treated with anti-inflammatory medication and application of cold or hot therapy. Get To Know What Possibly Could Be Causing Your Symptoms! If you have a subscapularis tendon tear, there are several things you can do to help treat it: Rest the shoulder joint as much as possible. However, they can occur in anyone who uses their shoulder muscles extensively. Methods: From August 1999 to June 2006, 38 patients with bursal-side partial-thickness rotator cuff tear were evaluated. The causes of subscapularis tear are as follows-. Namdari S, Baldwin K, Ahn A, et al. Continuing to use your arm when it is painful prevents your supraspinatus tear from healing. Got an mri today and my report said the following "inflammatory process of the subscapularis tendon and supraspinatus tendon with intrasubstance injury. Partial thickness cuff tears can be found incidentally on MRI scanning and may not be the source of pain. In the image below we see the supraspinatus tendon, the long head of the biceps tendon, and the subscapularis tendon. We follow a strict editorial policy and we have a zero-tolerance policy regarding any level of plagiarism. 2006;186(2):454-9. Shoulder impingement syndrome is the most common problem with one-in-five people having symptoms at some point in their lives. At the time the article was last revised Yahya Baba had This article on Epainassist.com has been reviewed by a medical professional, as well as checked for facts, to assure the readers the best possible accuracy. First of all, the subscapularis is the main muscle involved in the turning of the arm inward and it is also responsible for any lifting movement you will be doing across your chest. Subscapularis tendon tears are a less common rotator cuff tear, and have been considered more difficult to diagnose pre-operatively (both clinically and radiological) and have been known as a "hidden lesion" 5. RULING ON ENTITLEMENT 1. The high signal can be from a linear tear within the substance of the tendon (also the result of wear and tear on the tendon). Muscle transfer this operation is indicated in cases of tears that are old and chronic, being too large even for direct repair. Our articles are resourced from reputable online pages. Read about causes, seeing a doctor. If a tear is large or causes significant pain, you might need surgery. Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear. The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. Images MR arthrography with axial T1-weighted fat-suppressed and coronal PD images. The one injury that is known to cause subscapularis tears is a dislocation of the shoulder joint in patients over the age of 40 or 50. As a result, huge forces go through the supraspinatus and other rotator cuff muscles. The cookie is used to store the user consent for the cookies in the category "Analytics". A logical rationale. Supraspinatus tendinopathy is a common and disabling condition that becomes more prevalent after middle age [1] [2] and is a common cause of shoulder pain [3] [4]. A piece of the big pectoral muscle is transferred to the affected area. This cookie is set by GDPR Cookie Consent plugin. It is mandatory to procure user consent prior to running these cookies on your website. About two- thirds of this muscle is made up of tendons which makes it prone to injuries, particularly in athletes who indulge in swimming, playing tennis or throwing actions. Tears of the rotator cuff come in all shapes and sizes. 2012;28(11):1592-600. some loss of motion in your shoulder. Subscapularis muscles provide over 50% of muscle and tendon mass to support shoulder joint. When Is a Reverse Total Shoulder Replacement the Right Option to Relieve Shoulder Pain? subscapularis tendon tear on the contrary is localized over anterior shoulder joint. Pain may also be induced with inward motion of the arms. AJR Am J Roentgenol. The above tests can help your doctor narrow down possible conditions, but an MRI can help them more definitively diagnose the tear, as well as see how serious the tear is. These include: In young people, an injury is the most common cause of a subscapularis tear. Ice the shoulder joint regularly. Your doctor or physical therapist will give you exercises you can do to improve your range of motion and strengthen your subscapularis. Severe pain may continue after several surgeries to repair tendon or muscle tear. Skeletal Radiol. Here are 10 of the best foods that aid healing. Mike is creator & CEO of Sportsinjuryclinic.net. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. Transverse friction massage should only be carried out by a trained professional such as a physical therapist as success relies on a good knowledge of anatomy and structural organisation of the tissue so that they can be applied to the exact site of the supraspinatus tendonitis lesions, in the correct direction and at the right depth for the appropriate duration and frequency. Bergin D, Parker L, Zoga A, Morrison W. Abnormalities on MRI of the Subscapularis Tendon in the Presence of a Full-Thickness Supraspinatus Tendon Tear. The disease or torn tendon of the rotator cuff is isolated and removed. Subscapularis tears account for ~4% (range 2-6%) of rotator cuff tears 3. Surgical treatment involves exposure of tendon and the torn ligament is identified. It should not delay or substitute medical advice, diagnosis or treatment. After surgery, youll wear a brace that will keep you from rotating your arm outwards for about six weeks. The Reflex Health app is a great tool for measuring subscapularis tendon tears. A Frozen shoulder passes through, A dislocated shoulder occurs when the humerus bone displaces forwards out of the joint. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Stretch the muscles around the shoulder joint regularly. This cookie is set by GDPR Cookie Consent plugin. Rotator cuff tears may also occur in relation to acute injuries such as a fall onto the shoulder or other injury. To compensate, four muscles, known collectively as the rotator cuff, work together as the key dynamic stabilising muscles of the shoulder supraspinatus, infraspinatus, teres minor and subscapularis. Subscapularis tendon tears can affect shoulder range of motion in several ways. Got an MRI today and my report said the following "inflammatory process of the subscapularis tendon and supraspinatus tendon with intrasubstance injury. The supraspinatus is part of the rotator cuff of the shoulder. A supraspinatus tear is a tear or rupture of the tendon of the supraspinatus muscle. It is a tear that occurs in the middle layers of a tendon and not on the outside layers. However, it is unknown how repair of completed high-grade partial . Unable to process the form. Written By: Chloe WilsonBSc (Hons) PhysiotherapyReviewed By: SPE Medical Review Board. Tears of the subscapularis tendon are less common than supraspinatus and infraspinatus tendon tears (commonly simply known as ' rotator cuff tears '). Lie on your back and bend your elbow so that your fingers are pointing up and your elbow is on the ground next to you. When your arm is internally rotated, it means that your palm is facing back, behind your body. The role of anterior deltoid re-education in patients with massive irreparable degenerative rotator cuff tears. Direct shoulder joint or chest wall impact can cause partial or full thickness tear. But the huge range of motion at the shoulder puts it at much greater risk of injury. During the procedure, the tendon is replaced or treated as per the severity of the condition, Pec Major Transfer- This surgical procedure is adopted in case of chronic tears. It might also include physical therapy, especially if youre older. In our study, the overall incidence of subscapularis tendon tears associated with full-thickness tears of the . Rotator cuff tears (RCTs) usually involve the infraspinatus or supraspinatus tendons. After four weeks, the sling is removed and the therapy is ensued by a physical therapist. Second, if the subscapularis tendon is severely torn, it may not be able to function properly, which can also limit the range of motion in the shoulder joint. Lean forward with one arm on a table for support and the affected arm hanging at your side. Axial sonogram (transverse) of right . It also provides helpful tips and exercises to help you recover from your subscapularis tendon tear. An example of data being processed may be a unique identifier stored in a cookie. Findings helpful for the diagnosis of subscapularis tendon tears: increased sensitivity (~75%) of subscapularis tears has been demonstrated when two of the following four findings are . 9. They may occur as part of a degenerative process where the tendon progressively becomes weaker and wears out or they may be precipitated by impingement. Download our Mobile App now! The Pectoralis major muscle is transferred in place of the subscapularis as it has the capability to perform the same function, Sufficient rest is required for the affected shoulder and all activities that cause stress to the joint need to be avoided, Injecting cortisones into the affected part may provide immediate relief, Post-surgery, physical therapy and gradual mobility training may be helpful in regaining movement and strength, The operated arm may be immobilized using a sling for a few days or weeks. Mild supraspinatus tendonitis often goes unnoticed but what typically leads people to seek medical advice is shoulder and upper arm pain. Most surgery for a subscapularis tear is done arthroscopically, which means your doctor inserts a camera into your shoulder through a small slit and uses the camera to guide the surgery. These cookies track visitors across websites and collect information to provide customized ads. Subscapularis Tendinitis: Causes, Symptoms, Treatment, Recovery, FAQ on Subscapularis Tendon Repair Surgery, Impingement Syndrome or Rotator Cuff Tendinitis: Causes, Symptoms, Diagnosis, Treatment, Exercise, Home Remedies, Dietary Dos and Donts for Migraine Sufferers, Shirshasana (Headstand) Versus Inversion Therapy Using Inversion Table, Understanding Joint Pain and Tips to Get Relief Using Home Remedies, Erectile Dysfunction: Does Opioid Cause ED, Libido: Opioid Induced Female Sexual Dysfunction, Facilitate abduction and adduction movement at the shoulder joint, Assists in internal and external rotation of shoulder joint, Internal rotation of humerus at the shoulder joint. This article gives information about the following: The Subscapularis muscle is an extremely powerful muscle of the rotator cuff which facilitates inward movement of the arm. These include: These shoulder conditions may occur alongside supraspinatus tendonitis or on their own. Work injuries that involve a lot of overhead lifting, sport injuries that involve excessive upper-arm motion and traumatic injuries such as a car accident can cause fraying or tearing of the rotator cuff. It could be coming from your latissimus dorsi. Imaging findings for subscapularis tendon pathology are similar to those elsewhere with a few specific features that may aid in diagnosis. Some symptoms of a subscapularis tear are very similar to symptoms of other rotator cuff tears. Subscapularis Tendinitis usually occurs due to a direct trauma to the arm like that in a fall on the shoulders or arm or as a result of a sporting injury. Treatment for a subscapularis tear usually depends on the tear size and how much the tear negatively impacts your life. Most joints get their stability from their bone structure but the shoulder sacrifices bony stability for mobility. Cortisone injections these are applied exactly to the affected area, helping the injured tendon and muscle to faster recover. The disease or torn tendon of the rotator cuff is isolated and removed. In time, tears may also develop in the supraspinatus tendon leading to a partial or complete rotator cuff tear. Usually, almost all the patients undergoing the procedure experience almost complete recovery from the symptoms postprocedure. Positioning during the test prevents synergistic . The biceps tendon may shift in or beneath the subscapularis tendon with subscapularis tendon disruption. Methods: The records on eighty-four shoulders that had undergone open repair of the subscapularis tendon were reviewed. 5. The anterior section of rotator cuff is formed by the spread of tendon of subscapularis muscle. Partial-thickness tears may be classified further as occurring on the articular or bursal surface of the tendon. (2014). Partial or full thickness tear of subscapularis muscle is repaired by arthroscopic surgery. Subscapularis tendon rupture in an 8-year-old boy: a case report. Learn about its causes and home exercises that can help. It is structurally a part of the rotator cuff which consists of the supraspinatus . Sewick A, et al. Subscapularis tears can have intermediate or fluid-like intrasubstance tendon signal, tendon margin irregularity, tendon defect and/or tendon retraction 8. The subscapularis muscle is one of the four rotator cuff muscles. When your injury has healed and you are pain-free, begin. Fraying occurs because of excessive force on the rotator cuff that increases the stress in the tendons and causes tears of the tendon . [1,5] Partial-thickness articular surface rotator cuff tears (PTASRCTs) are at least twice as common as bursal-sided tears[6,7] and usually . It is a passive restraint in neutral, but not abduction. This muscle is often used by people who practice different types of sports, including swimming, racquetball and throwing spears or weights. Trauma fall or accident, especially car accidents in which there is a direct impact with a solid object or work accidents where the shoulder joint is in full impact with a solid object or surface, leading to the partial or full tear of the subscapularis muscle. An intrasubstance tear is a partial tear of a tendon or cartilage. The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". The surgery can be performed by arthroscopy or open surgery depending on the surgeon's expertise, tear pattern and patient. The confirm the diagnosis of Subscapularis Tendinitis, the treating physician will evaluate the shoulder thoroughly for any sort of abnormality in the range of motion by asking the individual to elevate the elbows and internally rotate the forearms. Whilst supraspinatus tendonitis is one of the most common shoulder complaints, there are a number of other conditions that present in a similar way or that often go hand in hand with painful arc syndrome. The subscapularis muscle is the strongest muscle of this group that is located on the front side of the upper arm. Subscapularis muscle is a large triangular muscle that lies underneath and is attached to the inner surface of scapula. AC joint separation. Learn about causes of uneven hips, such as scoliosis. Cortisone with local anesthetics injected in and around the injured tendon and muscle. The clinical prevalence of subscapularis tendon tears has been estimated at ~15% (range 5-30%) although is higher in patients undergoing rotator cuff surgery at ~55% (range 49-62%) and in cadaveric studies ~33% (range 29-37%) 1,4,9. Subscapularis tendon forms the major portion of the anterior section of rotator cuff. You can learn more about how we ensure our content is accurate and current by reading our. Studies have shown that the tear usually gets larger affecting the quality of the muscle. from your distinguished work, thank you." Examiner lifts the patients hand away from the shoulder during test. A common misconception is that Deep Transverse Friction Massage is painful, but when done correctly this is not the case. The Subscapularis Muscle is usually injured in individuals who participate in sporting activities which require frequent throwing like baseball etc. Supraspinatus symptoms may come on suddenly after an injury, or build-up gradually on and off over years with no obvious cause. These muscles help you lift and rotate your arm. The cookie is used to store the user consent for the cookies in the category "Other. Reference article, Radiopaedia.org (Accessed on 05 Mar 2023) https://doi.org/10.53347/rID-97658, see full revision history and disclosures, Patte classification of rotator cuff tendon retraction.