Occult Interpositional Rotator Cuff - an Extremely Rare Case of Traumatic Rotator Cuff Tear

Abstract

Traumatic interposition of a rotator cuff tendon in the glenohumeral joint without recognizable glenohumeral dislocation is an unusual complication after shoulder trauma. Here we report the clinical and imaging presentations of a 17-year-old man with trapped rotator cuff tendons in the glenohumeral joint after a bicycle accident. The possible trauma mechanism is also discussed.

Glenohumeral interposition of rotator cuff stumps: a rare complication of traumatic rotator cuff tear

“…Most cases reported in the literature are associated with high-energy trauma, with episodes of traumatic GHJ luxation ( 1 - 5 ) ; however, like in the present case, the history of luxation is not always well established ( 3 ) . As our patient was initially assisted in other service, such a possibility cannot be completely ruled out.…”

“…In the present case, as well as in the literature review, the authors highlight the role played by MRI in the identification of post-trauma interposition of soft tissues in the GHJ ( 1 , 2 , 5 ) . Such a role is not restricted to cases involving the shoulders, and MRI has been utilized, for example, to detect post-trauma periosteal interposition in growth cartilage fracture in children and adolescents ( 11 , 12 ) .…”

“…Difficulty or incapacity to reduce GHJ luxation is not common ( 1 - 3 ) . Irreducible GHJ luxation may be related to bone tissue or soft tissues interposition ( 1 , 2 , 4 , 6 - 10 ) .…”

“…Difficulty or incapacity to reduce GHJ luxation is not common ( 1 - 3 ) . Irreducible GHJ luxation may be related to bone tissue or soft tissues interposition ( 1 , 2 , 4 , 6 - 10 ) . Amongst the causes associated with soft tissues interposition, one can mention, for example, interposition of the long head of biceps ( 9 ) and interposition of the musculocutaneous nerve ( 10 ) ; however, interposition of rotator cuff tendons, particularly the subscapularis tendon, is highlighted ( 2 , 4 , 5 , 7 , 8 ) .…”

“…Traumatic rotator cuff injury is rarely observed in young patients and generally occurs after high-energy trauma. Even more rarely, traumatic rotator cuff injury may be associated with interposition of stumps or more than one of the rotator cuff tendons between the humerus and the glenoid ( 1 - 5 ) . In the case of rotator cuff stumps interposition in the glenohumeral joint (GHJ), the most common clinical presentation is articular blockage, many times with persistence of subluxation and/or irreducible luxation of the GHJ ( 4 - 8 ) .…”