Saturday, September 24, 2016

Partial thickness tear

Partial thickness tear: A partial thickness tear appears on fat-suppressed T2-weighted MR images as fluid signal intensity with thinning, or an incomplete gap, in the tendon. The supraspinatus tendon is usually about 12 mm in average cranio-caudal thickness. Partial thickness tears are classified according to their depth into either grade I, in which less than one fourth of the fibres is torn; grade II, when more than one fourth and less than half of the tendon thickness is torn and grade III, when more than half of the tendon thickness is torn.
According to the tear site, partial thickness tears of the supraspinatus tendon are classified into bursal; articular surface or intra-tendinous tearsre6).. Articular surface tears are more common.

Partial interstitial supraspinatus tendon tear. Coronal oblique fat-sat proton-density-weighted image showing focal high signal within the supraspinatus tendon fibres (arrow). Also note the associated high signal intensity fluid in the subacromial subdeltoid bursa.

The difference between partial thickness interstitial tear and tendinosis is that when you look to T1 and Proton density will appear in the first as hypo intense signal (tear) and the second as intermediate (tendinosis) signal which could be in the tear more hyper intense; so to be sure from your diagnosis look to stir images; in the tear it will be exaggerated like fluid while in the tendinosis it will decreased in intensity.

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