A Rare Presentation of a Full-Thickness Rotator Cuff Tear With a Confluent Partial Articular-Sided Tear

Rotator cuff tears (RCTs) are common injuries that often go undiagnosed. While there is strong literature addressing the management of both partial- and full-thickness tears of the supraspinatus, there is little to no literature describing both tears occurring concurrently. This is the first case reported in the context of a full-thickness RCT with a partial-thickness extension. It provides the clinical and radiographic context in which this patient was seen, as well as the operative guidelines used to achieve a successful outcome. We report a 39-year-old male reviewed for shoulder pain following mechanical injury. A tear involving the supraspinatus was clinically suspected and radiologically confirmed, but an unusual signal in select MRI images hinted towards further pathology. This was identified as a concurrent partial-thickness tear during arthroscopic evaluation was subsequently incorporated in the final repair configuration. The partial-thickness tear can easily be missed when superimposed on a full-thickness tear. A high degree of clinical suspicion is needed for diagnosis, corroborated with certain MRI features. Identifying these tears in a timely fashion will allow proper treatment to be instituted. Patients with these peculiar injury patterns can expect better long-term outcomes and functional recovery with proper diagnosis and treatment.