Case Study

ORTHO – Insertional calcifying tendinopathy of the left supraspinatus in a 8 year old FS German Shepherd dog

This 8 year old FS German Shepherd dog presented with left front lameness. Physical exam: discomfort of left shoulder

DX

Insertional calcifying tendinopathy of the left supraspinatus

Image Interpretation

Ultrasound of the left shoulder – The biceps tendon is well delineated, regular in diameter and presents with uniform
echogenicity and echotexture. There is no tendon sheath effusion, no joint effusion and
no thickening of the synovial lining noted. The intertubercular groove surface is even
and smooth.
The distal insertion tendon of the supraspinatus presents with subjectively large
volume and at least three calcified bodies next to the greater humeral tubercle.
Dynamic scanning reveals contact with possible mechanical irritation between the
supraspinatus and biceps tendon.

Outcome

Even though mechanical irritation of the biceps by the enlarged supraspinatus tendon
appears to be possible a true impingement syndrome can be ruled out at this point as
there is no secondary tendovaginitis. The calcifying supraspinatus tendinopathy itself
is rarely of any clinical significance, therefore it is not convincing that the presenting clinical signs can be attributed to the changes described here. Consider other pathology leading to front limb lameness such as elbow dysplasia, spinal and other disorders.