T1 axial before and 5 months after surgery of a radial tunnel syndrome (= supinator syndrome). The postoperative examination was performed because of increasing weakness in the forearm. It shows a marked atrophy (purple arrows) and denervation edema (orange arrows) of the superficial part of the supinator muscle. Red arrows: Normal supinator muscle, superficial part. Green arrow: Normal supinator muscle, deep part. Blue arrow: Arcade of Frohse with deep branch of radial nerve.
It has already been pointed out, that the tendon quality is a very important factor regarding the outcome of rotator cuff reconstruction.[Chung SW et al.] Above all, in addition to the signs of tendinopathy, a delamination of the torn tendon should be highlighted. It is an additional negativ prognostic factor and complicates cuff repair. In delaminated tears the articular layer is usually retracted more than the bursal layer.[Bierry G et al.] Yet, imaging accuracy for determining the quality of a torn tendon is not known. Delaminating tear of the supraspinatus tendon. [...]
In the section on acromial types and downslope a case was added that shows that a lateral downslope or a type 3 acromion does not at all mean that damage to the supraspinatus tendon must occur. The findings may be asymptomatic. In addition, a case was added in which an acromion extending far to the side is accompanied by a rupture of the supraspinatus tendon.