Hyperechoic rotator cuff tendon tear

Purpose. To describe unusual rotator cuff tendon tears which are hyperechoic at ultrasonography (US). Materials and method. We retrospectively reviewed the shoulder US examinations of 100 patients with rotator cuff tear demonstrated by CT arthrogram with bursography. We included in this study hyperechoic foci without surrounding hypoechoic zone. A second US examination was performed after bursal distension. Results. Six (6%) hyperechoic foci were detected. The initial US diagnosis was tendinosis in five cases (n=5) and full thickness tear in one case (n=1). At repeat US examination, the hyperechoic area was completely or partially hypoechoic, probably because the tears were filled with the injected hypoechoic fluid. Conclusion. Some rotator cuff tears, filled with fibrinoid fragments, are probably underdiagnosed at US.