Is T2 hyperintensity in the canine supraspinatus tendon normal?

AJVR 2018

December 10, 2024

Sarah L. Pownder, Brian G. Caserto, Kei Hayashi, Mary Lou Norman, Hollis G. Potter and Matthew F. Koff

Background
Shoulder joint pain in dogs, especially related to the supraspinatus tendon, is often difficult to diagnose accurately due to its overlapping MRI features with diseased tendons. The study aimed to characterize MRI and histologic features of the supraspinatus tendon in nonlame dogs to aid in distinguishing normal from pathological findings.

Methods
This study analyzed 14 shoulder joints from 7 nonlame, 2-year-old male Beagle cadavers. MRI was conducted using multiple fluid-sensitive sequences to assess the tendon’s thickness, volume, and signal intensity. After imaging, histologic examination of the tendons was performed using various staining techniques to assess tissue composition and morphology.

Results
The supraspinatus tendon displayed a consistent trilaminar appearance on MRI, with a hyperintense central layer flanked by hypointense superficial and deep layers. Histologically, the tendon’s central substance was rich in water and glycosaminoglycans (GAGs), while the outer layers consisted of dense collagen fibers. No pathological features were observed, confirming these characteristics as normal for nonlame dogs.

Limitations
The study’s limitations include its focus on a uniform population (age, breed, and sex) and the use of cadavers instead of live subjects, which may affect tissue properties. Further research involving diverse populations and live imaging is necessary.

Conclusions
The study highlights that the trilaminar MRI appearance of the supraspinatus tendon in dogs is a normal finding, and a hyperintense central signal should not be misinterpreted as pathological without additional evidence. This baseline data can improve the accuracy of diagnosing supraspinatus tendinopathy in dogs.

Representative sagittal proton-density FSE (A), multiplanar gradient recalled acquisition (B), short tau inversion recovery (C), T2-weighted FSE and T2 with frequency-selective fat suppression (D), T2-weighted FSE with frequency-selective fat suppression (E), and spoiled gradient recalled echo (F) images of the shoulder joint of a nonlame 2-year-old sexually intact male Beagle cadaver. Notice that the supraspinatus tendon (arrows) has a trilaminar appearance and a hyperintense signal at its insertion on the greater tubercle of the humerus on all images.

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