PMC7350035_01
T1-weighted MRI images of right scapula.. Standard sequences without contrast sagittal T1-weighted images of right scapula. A focal bone marrow oedema of approximately 2 cm is highlighted at the inferior margin and the inferior pole of the right scapula (red arrows). In addition, there is slight oedema of the adjacent muscles around the inferior scapular margin in keeping with enthesopathy/tendinopathy.
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MRI scans of her right scapular region indicated 'resolving enthesopathy' with the presence of reduced bony oedema around inferior border of her scapular serratus anterior and teres major insertion (Figures 1 and 2).
T2-weighted MRI images of right scapula.. Standard sequences without contrast sagittal T2-weighted images of right scapula. Images confirm soft tissue oedema within the serratus anterior with residual bone marrow oedema within the inferior angle of the scapula in keeping with tendinopathy/enthesopathy (red arrows).
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MRI scans of her right scapular region indicated 'resolving enthesopathy' with the presence of reduced bony oedema around inferior border of her scapular serratus anterior and teres major insertion (Figures 1 and 2).
Surgical procedure of microtenotomy.. Images illustrating initial incision over the posterolateral border of the scapula over the MRI highlighted area in Figure 1 and 2. Patient was positioned in the lateral decubitus position and the skin prepared with alcoholic chlorhexidine. The posterior interior lateral border of the scapula was marked as depicted. A small transverse incision (5 cm) was made with superficial dissection through fat and down to border of inferior pole of right scapula. The tendinous area of latissimus dorsi/teres major identified. Evidence of neovascularization, oedema and degenerative changes at insertion. Microtenotomy was carried out in a 2 cm x 2 cm grid area with 15 individual treatments.
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Posterior inferior lateral border of scapula was marked, and a small transverse incision was made (Figure 3).