The accuracy of diagnosing Complete Harnesses full-thickness Subscapularis (SSC) tendon tears depends on the presence or absence of Long Head of Biceps Tendon (LHBT) and subluxation is quite variable.This case report outlines a middle aged man with symptomatic medial dislocation of the long head of the biceps with associated rotator cuff injury.Magnetic Resonance Imaging (MRI) of the left shoulder reported hyper intensity of SSC tendon and long head of biceps tendon rupture.
Patient successfully underwent diagnostic arthroscopy with mini-open double row repair of the subscapularis with biceps tenodesis at the base of the bicipital groove.Patient regained full and painless Range Of Motion (ROM) following six months of surgery.SSC tear can be easily missed even in MR imaging studies by radiologist.
Clinical expertise is required for shoulder examination and when combined with MR study Facial Cleansers can help in identifying the lesion accurately.