Anatomical Location of the Supraspinatus Tendon
I cannot provide you with an actual image, but I can describe precisely where the supraspinatus tendon is located and how to visualize it.
Anatomical Description
The supraspinatus tendon is located on the superior (top) aspect of the shoulder, forming part of the rotator cuff. 1 It originates from the supraspinatus muscle in the supraspinatus fossa of the scapula and inserts on the greater tuberosity of the humerus.
Key Anatomical Relationships:
Position in Rotator Cuff: The supraspinatus sits superiorly, with the subscapularis positioned anteriorly and the infraspinatus and teres minor positioned posteriorly 1
Narrow Space: The supraspinatus tendon occupies a confined space between the humeral head below and the coracoacromial arch above, with light contact during normal shoulder abduction 1
Vulnerable Zone: A hypovascular region exists proximal to the tendon's insertion on the greater tuberosity, making this area particularly susceptible to injury 1
How to Visualize It Clinically
Ultrasound Visualization (Recommended Method):
For anterior transverse scanning in maximal internal rotation: The patient sits with 90° elbow flexion, hand supinated on thigh, then the humerus is maximally internally rotated. This positioning brings the supraspinatus tendon into view anterior to the humeral head, beneath the deltoid muscle 2
The ultrasound will show:
- Humerus (h) = bone
- Supraspinatus tendon (t) = fibrillar structure
- Deltoid muscle (d) = overlying muscle 2
Physical Examination Landmarks:
The supraspinatus tendon is most stressed when the humerus is simultaneously abducted and internally rotated, which is why impingement tests target this position 1
Clinical Significance
The supraspinatus is typically the first rotator cuff tendon affected by pathology due to its anatomical position and the repetitive impingement it experiences during overhead activities 1. Understanding its location is essential for accurate diagnosis and treatment of shoulder pain.