Is an isolated infraspinatus tear real, or is it the zebra? Colin Rigney and Ryan Martin take apart the most heavily taught and least often seen tendon in the rotator cuff: why the infraspinatus rarely fails on its own, the two normal anatomic findings that get read as pathology, and how to tell an overlap artifact from a genuine tear.
What this episode covers:
- Why a cuff fails anteriorly to posteriorly, and what that means for your scan order
- The elongated myotendinous junction that gets called a bursal sided tear
- Cortical irregularity across the middle facet, and why it is not a Hill-Sachs
- Where the infraspinatus overlaps the supraspinatus, and the echogenicity change that fools people early in their scanning
- Anisotropy versus pathology when the two tendons sit 30 to 45 degrees oblique
- Assessing fatty atrophy in the posterior fossa, using teres minor as the landmark
- Treating the whole organ rather than one tendon
Courses mentioned in this episode:
- Live Shoulder Scanning Protocol
- MSK Ultrasound Evaluation of Rotator Cuff Tear vs Tendinopathy
- Every AMSKU course
New episodes every Tuesday. Watch on YouTube, or listen wherever you get your podcasts.
Chapters:
0:00 The zebra, and the overlap that fools you
0:20 From Probe to Practice
1:04 Why the infraspinatus, and why now
1:59 The honest reason behind the post
4:15 How often is it isolated?
4:57 The wrestler: a tear nobody predicted
5:43 Ultrasound is a tool, not the whole answer
7:01 Two normal findings that look like pathology
8:44 Where the infraspinatus overlaps the supraspinatus
9:56 Anisotropy versus pathology
11:07 Fatty atrophy and the notch of no name
12:22 Teres minor is your lighthouse
14:43 This is beyond beginner level
15:41 The courses that cover this
16:54 Treating the whole organ
19:46 The distal biceps window debate
22:37 The new machine
24:12 Wrap
0:00 The zebra, and the overlap that fools you
0:20 From Probe to Practice
1:04 Why the infraspinatus, and why now
1:59 The honest reason behind the post
4:15 How often is it isolated?
4:57 The wrestler: a tear nobody predicted
5:43 Ultrasound is a tool, not the whole answer
7:01 Two normal findings that look like pathology
8:44 Where the infraspinatus overlaps the supraspinatus
9:56 Anisotropy versus pathology
11:07 Fatty atrophy and the notch of no name
12:22 Teres minor is your lighthouse
14:43 This is beyond beginner level
15:41 The courses that cover this
16:54 Treating the whole organ
19:46 The distal biceps window debate
22:37 The new machine
24:12 Wrap
