|
Year |
2005 |
|---|---|
|
Question Number |
237. |
|
Category |
Shoulder and Elbow |
Question
A 30-year-old man who injured his arm in a fall from his roof underwent diagnostic arthroscopy because of persistent pain and weakness. A clinical photograph is shown in Figure 83. What is the most likely diagnosis?
1- Superior labrum anterior posterior lesion of the biceps anchor
2- Full-thickness tear of the infraspinatus tendon
3- Large Bankart defect
4- Buford complex (normal variant)
5- Partial deep surface tear of the supraspinatus
Figures
Answer (click for answer)
Correct answer: 5
The figure shows a partial thickness tear of the leading edge of the supraspinatus so answer #5 is correct. The patient is unlikely to have a large bankhart defect as his complaint is pain not instability, furthermore the labrum is not visualized in the photo. A SLAP tear is possible given the history but the figure does not show the biceps anchor so it would be impossible to diagnose from this figure. A Buford complex is a normal variant and is a foramen in the anterior labrum that can be confused with a bankhart or slap lesion. If this is fixed the patient will loose external rotation. The tear in this patient start just behind the biceps tendon so it is in the supraspinatus not the infraspinatus.
Reference: RECOMMENDED READINGS: Gartsman GM, Milne JC: Articular surface partial-thickness rotator cuff tears. J Shoulder Elbow Surg 1995;4:409-415.
Snyder SJ, Pachelli AF, Del Pizzo W, et al: Partial thickness rotator cuff tears: Results of arthroscopic treatment. Arthroscopy 1991;7:1-7.
