Case History
A 19-year-old right-handed female presented to our clinic with a chief
complaint of left shoulder activity-related pain of approximately six
months’ duration. She subsequently underwent six months of physical
therapy and received two subacromial cortisone injections with minimal
relief. On physical examination, she reported pain over the anterior and
lateral shoulder. She had pain with resisted supraspinatus testing but
full strength. She also had moderate discomfort with abduction and
external rotation (posterior impingement sign). There was mild
tenderness to palpation over the biceps tendon in the groove as well.
She had full range of motion and no anterior or posterior shoulder
instability. Subscapularis and infraspinatus tests were normal and she
had a negative O’Brien’s test, negative jerk test, and negative
subacromial impingement test. There was no scapular dyskinesis or
glenohumeral internal rotation deficit (GIRD). The remainder of her exam
was unremarkable.
An MRI showed a partial supraspinatus tendon tear and moderate
tendinosis of the intra-articular portion of the long head of the biceps
(LHB). There was no evidence of anterior or superior labral tear. The
upper border of the subscapularis tendon was intact. She opted for
surgical management after a thorough discussion of operative and
non-operative treatment options.