Suture material may be seen as specular echoes deep in the trough. Scanning the arm in extension and internal rotation may be necessary to visualize the site of tendon reimplantation, especially when it is medial. Failure to scan in this position may lead to false-positive diagnosis. Such a maneuver, however, should be used with care, especially in the immediate postoperative period, to avoid reinjury of the friable newly reimplanted tendons. Tendons, especially the supraspinatus, are often echogenic and thinned when compared with those of the contralateral shoulder.
Joint effusions are common and best visualized along the biceps tendon.
Normal postoperative appearance in a patient after rotator cuff repair. Note the thinning of the left supraspinatus tendon. Other normal postoperative appearances of the right supraspinatus tendon. Note the shadowing suture or calcification. Sonographically, recurrent tears most often appear as absence of the cuff.