PMC6786308_01
Coronal T2 with Fat Saturation showing partial articular surface insertional tear of the anterior infraspinatus and posterior supraspinatus tendons prior to treatment (a) followed by improvement in partial articular surface insertional tear of the anterior infraspinatus and posterior supraspinatus tendons 12 months post-treatment (b)
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Fig1
Inc., Malvern, PA) and images were evaluated by a musculoskeletal radiologist (MAP). Imaging revealed moderate, heterogenous, and increased signal intensity within the supraspinatus tendon compatible with tendinosis; severe heterogenous increased signal intensity within the infraspinatus tendon compatible with severe tendinosis; a 50 percent partial articular surface insertional tear of the anterior infraspinatus and posterior supraspinatus tendons that measured up to 10 mm in the transverse dimension and 12 mm in the anteroposterior dimension; a small amount of fluid in the subacromial/subdeltoid bursa consistent with bursitis; acromioclavicular joint arthropathy; and moderate edema within the infraspinatus muscle belly near the musculotendinous junction compatible with grade 1 strain (Fig. 1a). The tear measured 20% the thickness of the tendon (5 mm in the transverse dimension and 5 mm in the anteroposterior dimension), which corresponded to a decrease of 50% when compared to initial assessment (Fig. 1b).
Long Axis image of 0.63 cm articular sided tear, partial thickness tear of the supraspinatus tendon a. Long Axis image of MFAT being injected, using an in-plane approach, into the supraspinatus partial-thickness tendon tear b
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Fig2
Ultrasound examination of the right shoulder demonstrated a 0.63 cm articular-sided, partial-thickness tear of the supraspinatus tendon, degenerative changes of the acromioclavicular joint and posterior labrum, and mild cortical irregularity (Fig. 2a). The rotator cuff and other pertinent shoulder structures were visualized using ultrasound and then 2.5 mL of MFAT was injected into the supraspinatus tendon tear, 2 mL into the subacromial bursa, and 1 mL into the acromioclavicular joint (Fig. 2b) using an 18-gauge x 3.5'' needle.
Outcome measures showing improvement in Numerical Rating Scale over 12 months period a. Wheelchair User Shoulder Pain Index results for patient over 12 months period b, followed by Brief Pain Inventory Interference Items results for the patient over the same period of time c
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Fig3
During his 12-month follow-up, NRS, WUSPI, and BPI-17 scores continued to be reported as 0 (Fig. 3a-c) and he reported feeling "very much improved" on his PGIC at 12 months.