Isolated Goutallier Grade 4 supraspinatus atrophy: a rare case without rotator cuff tear or nerve compression.
Trisha Mukherjee, Arash D Tehranzadeh, John M Itamura et al.
✦ AI-curated · Sources linked
Case in brief
A 66-year-old male presented with worsening anterior shoulder pain following a workout injury. Imaging revealed isolated Goutallier Grade 4 fatty atrophy of the supraspinatus muscle, with intact rotator cuff tendons and preserved infraspinatus morphology. No evidence of tendon tear or nerve compression was found. The case suggests a possible chronic subclinical denervation pattern as the underlying cause.
What made this case unusual
This case is notable for the isolated atrophy of the supraspinatus muscle without concurrent infraspinatus involvement or typical structural causes, such as rotator cuff tears or nerve compression.
Diagnostic / clinical pearl
Clinicians should consider atypical neural etiologies, such as selective nerve injury or Parsonage-Turner syndrome, in cases of isolated supraspinatus atrophy without classic rotator cuff pathology.
Why it matters
This case underscores the importance of MRI in diagnosing atypical presentations of shoulder pathology and highlights the need for awareness of potential neural causes of muscle atrophy.