Partial-thickness, full-thickness, or complete tear

Supraspinatus tendon tears most common close to or at insertional area, especially anterior fibers

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  Most tears are avulsive type with retraction from insertional area; leading edge

  
  
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  Supraspinatus tears extending > 2.5 cm posterior to rotator cuff interval involve infraspinatus tendon

Isolated tear of infraspinatus tendon is less common

Underlying tendinosis is often present

Partial tears of rotator cuff: Determine location and percentage of depth

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  Bursal sided: Tear abuts bursa surface; may see bursal fluid

  
  
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  Articular sided: Tear abuts hyaline cartilage

  
  
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  Intrasubstance: Tear is between tendon fibers and can extend to insertion

  
  
  
  
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    No contact with tendon surface; not visible at arthroscopy or bursoscopy

  
  

Complete tear

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  Discontinuity of tendon filled with anechoic fluid

  
  
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  Focal flattening or concavity of bursal surface

  
  
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  With complete retraction, tendon may not be visualized; humeral head migrates superiorly

Cortical irregularity is indirect sign of chronic rotator cuff tear

Visualization of biceps tendon at rotator cuff interval ensures complete assessment of anterior supraspinatus where tears are most common

With empty bicipital groove, ensure biceps is not dislocated or surgically relocated

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  Look for distal retracted tendon stump

Assess for muscular atrophy, which affects prognosis

Always confirm findings in 2 planes