PMC6409071_01
Oblique coronal magnetic resonance images of the left shoulder. (a) T1-weighted images. (b) T2-weighted images. An extensive hematoma was seen in the glenohumeral joint and the subacromial and subdeltoid bursas, which was shown as low signal intensity in T1-weighted images and high signal intensity in T2-weighted images. Bony erosion on the undersurface of the acromion was detected (white arrows).
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fig1
MRI demonstrated large hematomas in both the glenohumeral joint and the subacromial space and bony erosion of the lateral acromion (Figure 1).
Arthroscopic views. (a) In the glenohumeral joint, the long head of the biceps was torn and the intra-articular portion had disappeared (LHB: long head of the biceps; GL: glenoid; HH: humeral head). (b) Bleeding was noted from the subacromial erosion (arrows). (c) Acromioplasty was performed (arrows) following coagulation of the bleeding points. The rotator cuff was intact (SSP: supraspinatus).
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fig2
There were no abnormal findings in the glenohumeral joint except for a chronic tear of the biceps tendon (Figure 2(a)). A crater-like erosion was observed on the undersurface of the acromion, at which bleeding was seen (Figure 2(b)). Bleeding points were coagulated with a radiofrequency system and anterior acromioplasty was performed with a motorized shaver arthroscopically (Figure 2(c)).
PMC6409071_02
Oblique coronal magnetic resonance images of the left shoulder. A hematoma was seen in the anterior portion of the subacromial bursa in T2-weighted images (a). Subacromial bony erosion was detected in T1- (b) and T2-weighted images (c) (arrows). Bursal-side partial tear was also seen.
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fig3
MRI demonstrated a hematoma in the anterior portion of the subdeltoid bursa and bony erosion of the lateral acromion, similar to case 1 (Figure 3).
Arthroscopic views. (a) Crater formation on the undersurface of the acromion and bleeding was noted from the subacromial erosion (arrows). (b) Irregularity of the greater tuberosity was observed. (c) Osteophytes of the greater tuberosity were removed by a shaver following coagulation of the bleeding points. (d) Bursal-side partial-thickness tear was not repaired (GT: greater tuberosity; DL: deep layer of the cuff; SL: superficial layer of the cuff).
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fig4
Crater formation on the undersurface of the acromion and irregularity of the greater tuberosity were observed, which seemed to be kissing lesions (Figures 4(a) and 4(b)). The undersurface of the acromion was coagulated and the greater tuberosity was abraded to avoid impingement (Figure 4(c)). The bursal-side partial tear was not repaired at that time (Figure 4(d)).