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Figure 19b. Extensive subscapularis tendon tear with nondislocated tendon of long head of the biceps brachii. (a, c) Transverse and (b) coronal intermediate-weighted MR images (2500/28) obtained with fat saturation. (a, b) Acute shoulder injury with "natural" arthrogram effect due to intraarticular fluid. Complete tear of subscapularis tendon (*) is visible, but long head of biceps brachii tendon (arrow) is still held in the groove by thickened pulley ligaments (arrowhead). (c) Section cranial to a shows superior portion of lesser tuberosity covered by thickened irregular tissue (arrowhead), consistent with injured but not completely disrupted medial pulley ligament complex, with partial volume averaging of long head of biceps brachii tendon proximal to entrance to the groove. Lateral portion of sling appears to be injured (arrow).
