MSK Ultrasound Infraspinatus: The Normal Findings That Look Like a Rotator Cuff Tear

Is an isolated infraspinatus tear real, or is it the zebra? Colin Rigney and Ryan Martin take apart the most heavily taught and least often seen tendon in the rotator cuff: why the infraspinatus rarely fails on its own, the two normal anatomic findings that get read as pathology, and how to tell an overlap artifact from a genuine tear. What this episode covers: Why a cuff fails anteriorly to posteriorly, and what that means for your scan order The elongated myotendinous junction that gets called a bursal sided tear Cortical irregularity across the middle facet, and why it is not a Hill-Sachs Where the infraspinatus overlaps the supraspinatus, and the echogenicity change that fools people early in their scanning Anisotropy versus pathology when the two tendons sit 30 to 45 degrees oblique Assessing fatty atrophy in the posterior fossa, using teres minor as the landmark Treating the whole organ rather than one tendon Courses mentioned in this episode: Live Shoulder Scanning Protocol https://www.amsku.com/courses/live-sh... MSK Ultrasound Evaluation of Rotator Cuff Tear vs Tendinopathy https://www.amsku.com/courses/musculo... Every AMSKU course: https://www.amsku.com/all-courses/ New episodes every Tuesday. Watch on YouTube, or listen wherever you get your podcasts. Chapters: 0:00 The zebra, and the overlap that fools you 0:20 From Probe to Practice 1:04 Why the infraspinatus, and why now 1:59 The honest reason behind the post 4:15 How often is it isolated? 4:57 The wrestler: a tear nobody predicted 5:43 Ultrasound is a tool, not the whole answer 7:01 Two normal findings that look like pathology 8:44 Where the infraspinatus overlaps the supraspinatus 9:56 Anisotropy versus pathology 11:07 Fatty atrophy and the notch of no name 12:22 Teres minor is your lighthouse 14:43 This is beyond beginner level 15:41 The courses that cover this 16:54 Treating the whole organ 19:46 The distal biceps window debate 22:37 The new machine 24:12 Wrap