PMC4891563_01
45-year-old man with multiple sclerosis and spastic shoulder. T1 weighted sequence demonstrating fibrosis/scar at the trapezius insertion, but normal musculature without mass. (Powerpoint Slide)
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T1 weighted sequence without contrast demonstrated high signal in the trapezius insertion site consistent with the presence of blood products (Fig. 1A). T2 FSE (fast spin echo) fat saturation sequences demonstrated high signal abnormality at the trapezius insertion on the scapular spine corresponding to edema and likely muscle-tendon injury (Fig. 1B). The trapezius muscle belly was bunched up, and the tendon was surrounded by high signal and medially retracted (Fig. 1C). With contrast administration, there was mild enhancement around the retracted tendon, indicating subacute to chronic injury with inflammatory reaction or active fibrosis (Fig. 1D).