Albany Medical College Virtual Anatomy Lab

Lab2 - Module 2 - Anatomy of the Scapular Region: Page 7 of 7


CASE REPORT CONCLUSION:

Based on the examination and the most likely diagnosis would be a rotator cuff tear. The most likely muscle involved would be the supraspinatus. Remember the supraspinatus initiates the first 10 – 15 degrees of glenohumeral joint abduction. Additionally, the patient exhibited a positive empty can test which is indicative of a supraspinatus tear.

The patient was unable to lift their arm over their head. That could be due to the weakened state of the supraspinatus so the deltoid never gets into a position to take over. Or it could be because of pain from the torn tendon hitting the acromion process or coracoacromial ligament.

There are many things that could also cause similar symptoms. One way to differentiate is with a MRI.

Focus on the coronal cut of the left shoulder. Use the Highlight Tool to idententify the structures of the left shoulder. Compare to the accompanying MRIs of the left shoulder. Notice the differences between Figure 1 and Figure 2.
rotator tear

DIFFERENTIAL DIAGNOSIS:

  • • Impingement (bursitis)

  • • Labral Tears

  • • Long Head Biceps Injuries

  • • Glenohumeral ligament injuries

  • • Acromioclavicular and/or coracoclavicular ligament injuries

  • • Osteoarthritis

  • • Adhesive capsulitis

  • • Proximal peripheral neuropathies (recall the suprascapular nerve entrapment – see posterior triangle lecture)

  • • Cervical radiculopathy

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