Partial-Thickness Tears

Patients with chronic lateral ankle injuries and functional instability can have various problems that can cause confusion reaching a specific diagnosis. Although uncommon, PTD is one cause of lateral ankle dysfunction. PTD may include fissures, fraying, partial thickness tears, full thickness tears, subluxation, or complete... 

Fig. 6.72a,b. Bursal-side partial-thickness tears of the supraspinatus tendon. Two different cases, a Long-axis 12-5 MHz US image over the supraspinatus tendon shows focal herniation of hypoechoic bursal tissue within the defect (arrowheads). Note the thickened bursal walls (arrow) and the loss of the normal convexity of the peribursal fat at the site of the tear. GT, greater tuberosity, b Long-axis 12-5 MHz US image over the supraspinatus tendon reveals hyperechoic peribursal fat filling a small superficial defect (arrowheads) in the absence of local effusion. 

Fig. 6.92a-d. Intramuscular cyst, a Long- and b short-axis 12-5 MHz US images over the supraspinatus muscle (arrows) obtained by placing the transducer immediately posterior and medial to the acromioclavicular joint reveal an intramuscular cyst (asterisk). In this particular case, the cyst was associated with an articular-side partial-thickness tear of the supraspinatus tendon. Acr, acromion Cl, clavicle, c Oblique coronal fat-suppressed Gd-enhanced Tl-weighted and d sagittal proton density MR imaging correlations. In c, contrast enhancement is seen in the muscle tissue surrounding the cyst... 

Yen CH, Chiou HJ, Chou YH et al (2004) Six surgery correlated sonographic signs for rotator cuff tears emphasis on partial-thickness tear. Clin Imaging 28 69-76 Zarins B, Rowe CR (1984) Current concepts in the diagnosis and treatment of shoulder instability in athletes. Med Sci Sports Exerc 16 444-448... 

Fig. 8.41. Partial-thickness tear of the common extensor tendon. Long-axis 12-5 MHz US image in a manual laborer who presented with acute onset of lateral elbow pain reveals a linear hypoechoic split star) extending from the lateral epicondyle (LE) through the substance of the common extensor tendon origin. The torn deep libers arrowheads) are retracted just distal to the hypoechoic area. Note the integrity of the underlying lateral ulnar collateral ligament asterisks). RH, radial head...

In medial collateral ligament injuries, US reveals a thickened and heterogeneous ligament (Fig. 14.69). Partial-thickness tears most commonly affect the meniscofemoral ligament and can be difficult to... 

Fig. 16.55. Partial-thickness tear of the deltoid ligament. Coronal 12-5 MHz US image over the medial ankle reveals hypoechoic thickening of the cranial portion of the tibiocalca-neal ligament consistent with a partial tear. Note the discrepant size between the injured (arrows) and the intact (arrowheads) portion of the ligament. C, calcaneus...

Fig. 16.79 a-c. Partial rupture of the Achilles tendon. Longitudinal 12-5 MHz US images demonstrate a spectrum of appearances of partial-thickness tears of the Achilles tendon in three different cases, all surgically proven, a The echotexture of the posterior half of the Achilles tendon is abnormally hypoechoic (asterisks) with loss of the fibrillar pattern, b A hypoechoic interstitial defect (asterisks) in the longitudinal direction is visible within the tendon substance. C, calcaneus c The anterior border of the Achilles tendon is wavy (arrows) and the echotexture appears diffusely hypoechoic. In this case, there wis discontinuity of the anterior fibers from the soleus muscle... 

The advisability of corticosteroid injection into the glenohumeral joint of patients with rotator cuff pathology is debated. Some authors prefer not to inject the drug in patients with partial-thickness tears of the rotator cuff to prevent progression of tendon damage. Others believe that injection inside the subacromial bursa can be rather safe in these circumstances. 

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