Shoulder radiograph with mineralisation of the supraspinatus tendon insertion

Supraspinatus Tendinopathy in 327 Dogs: A Retrospective Study

Sherman O Canapp, Debra A Canapp, Brittany Jean Carr, Catherine Cox, Jennifer G Barrett

Published:  04/07/2016    in:  Articles

Shoulder radiograph with mineralisation of the supraspinatus tendon insertion

Objective: To report clinical findings and treatments for dogs with supraspinatus tendinopathy (ST).

Background: ST is a term used to describe tears, calcifying tendinopathy, tendinosis and/or injuries in and around the tendon of the supraspinatus muscle, and is a cause of forelimb lameness, especially in sporting and performance dogs.

Evidentiary value: This is a retrospective study of 327 dogs diagnosed with ST.

Methods: Medical records (2006 to 2013) were reviewed for history, signalment, prior treatments, physical examination findings, diagnostic imaging and arthroscopic findings, concurrent shoulder and elbow pathologies, and treatments performed.

Results: Dogs aged 4 months to 14 years (average 6.5 years; median 6 years) were diagnosed with ST. Performance and sporting dogs were 39.4% of the population, with 58.1% of them being agility dogs. Pain was elicited on palpation of the supraspinatus tendon in 49.3% of dogs. Shoulder radiographs in 283 dogs showed mineralisation in 13% of cases. MRI of the shoulder was performed in 31 cases and revealed findings indicative of ST, including hyperintensity of signal on T1 weighted image (or “spin-lattice”) and Short T1 Inversion Recovery (STIR) sequences of the supraspinatus tendon at its insertion on the greater tubercle and mineralisation of the supraspinatus tendon. Common ultrasonographic findings included increased tendon size (76%), irregular fibre pattern (74%), and non-homogeneous echogenicity (92.5%). The most common findings on shoulder arthroscopy were supraspinatus bulge (82.2%) and subscapularis pathology (62.4%). Elbow pathology was recorded in 54.5% of dogs. Treatment outcomes showed 74.6% of dogs failed to respond to non-steroidal anti-inflammatory drugs (NSAID) and 40.8% failed to respond to rehabilitation. 

Conclusions: These findings suggest concurrent shoulder and/or elbow pathology is not uncommon in dogs with ST. Further, ST often fails to respond to NSAID therapy and rehabilitation therapy. 

Application: Other treatments such as regenerative medicine should be considered. Future studies are still needed to assess the use and efficacy of regenerative medicine for ST.

Open AccessPeer Reviewed

Full Text:


Click to see References Click to hide References

  1. Marcellin-Little, D.J.  Levine, D. and Canapp S.O. (2007) The Canine Shoulder: Selected Disorders and Their Management with Physical Therapy. Clinical Techniques in Small Animal Practice, 22 (4), pp. 171-182.
  2. Canapp, S.O. and Gross Saunders, D. (2014) Common Conditions and Physical Rehabilitation of the Athletic Patient. In: Millis, D.L, Levine, D, Canine Rehabilitation and Physical Therapy. Second ed. Philadelphia, Elsevier Saunders.
  3. Canapp, S.O. (2013) Supraspinatus Tendinopathy in Dogs. In: Proceedings ACVS Symposium. San Antonio, TX 24 -26 April. American College of Veterinary Sports Medicine and Rehabilitation, pp. 504 – 506.
  4. Canapp, S.O. and Kirkby, K.A. (2013) Disorders of the Thoracic Limb. In: Zink M.C, Van Dyke J.B (eds),  223-249.
  5. Kujat, R. (1990) The Microangiographic Pattern of the Rotator Cuff of the Dog. Archives of Orthopaedic and Trauma Surgery, 109 (2), pp. 68-71.
  6. Sano, H. et al. (1997) Degeneration at the Insertion Weakens the Tensile Strength of the Supra Spinatus Tendon: A Comparative Mechanical and Histological Study of the Bone-Tendon Complex. Journal of Orthopaedic Research, 15 (5), pp. 719-726.
  7. Fransson, B.A. Gavin, P.R. and Lahmers, K.K. (2005) Supraspinatus Tendinosis Associated with Biceps Brachii Tendon Displacement in a Dog. Journal of the American Veterinary Medical Association, 227 (9), pp. 1429-1433.
  8. Arend, C.F. Arend, A.A. and Silva, T.R. (2014) Diagnostic Value of Tendon Thickness and Structure in the Sonographic Diagnosis of Supraspinatus Tendinopathy: Room for a Two-Step Approach. European Journal of Radiology, 83 (6), pp. 975-979.
  9. Gilliland, B.C. (1994) Relapsing Polychondritis and Miscellaneous Arthritides. In: K.G. Isselbacher, E. Braunwald, J.D. Wilson, J.B. Martin, A.S. Fauci, D.L. Kasper, (ed) Harrison’s principles of internal medicine. New York, NY: McGraw Hill. pp. 1706-1708.
  10. Lafuente, M.P. et al. (2009) Surgical Treatment of Mineralized and Nonmineralized Supraspinatus Tendinopathy in Twenty-Four Dogs. Veterinary Surgery, 38 (3), pp. 380-387.
  11. Evans, H.E. (1993) Miller's Anatomy of the Dog, ed 3. Philadelphia, Saunders. Pp. 225-231.
  12. Cullen, K.L. et al. (2013) Internet-Based Survey of the Nature and Perceived Causes of Injury to Dogs Participating in Agility Training and Competition Events. Journal of the American Veterinary Medical Association, 243 (7), pp. 1010-1018.
  13. Lewis. J.S. (2009) Rotator Cuff Tendinopathy. British Journal of Sports Medicine, 43 (4) pp. 236-241.
  14. Rees, J.D. Maffulli, N. and Cook, J. (2009) Management of Tendinopathy. The American Journal of Sports Medicine, 37 (9) pp. 1855-1867.
  15. Arrington, E.D. and Miller, M.D. (1995) Skeletal Muscle Injuries. The Orthopaedic clinics of North America, 26 (3) pp. 411-422.
  16. Almekinders, L.C. and Temple, J.D. (1998) Aetiology, Diagnosis, and Treatment of Tendonitis: An Analysis of the Literature. Medicine & Science in Sports & Exercise, 30 (8) pp. 1183-1190.
  17. Hurt, G. and Baker, C.L. (2003) Calcific Tendinitis of the Shoulder. Orthopaedic Clinics of North America, 34 (4) pp. 567-575.
  18. Hashimoto, T. Nobuhara, K. and Hamada, T. (2003) Pathologic Evidence of Degeneration as a Primary Cause of Rotator Cuff Tear. Clinical Orthopaedics and Related Research, 415 pp. 111-120.
  19. Dean, B.J.F. Franklin, S.L. and Carr, A.J. (2012) A Systematic Review of the Histological and Molecular Changes in Rotator Cuff Disease. Bone & Joint Research, 1 (7), pp. 158-166.
  20. Garcia, G.M. McCord G.C. and Kumar, R. (2003) Hydroxyapatite Crystal Deposition Disease. Seminars in Musculoskeletal Radiology, 7 (3), pp. 187-193.  
  21. Soslowsky, L.J. et al. (2000) Overuse Activity Injuries the Supraspinatus Tendon in an Animal Model: A Histologic and Biomechanical Study. Journal of Shoulder and Elbow Surgery, 9 (2), pp. 79-84.  
  22. Fransson, B.A. Gavin, P.R. and Lahmers, K.K. (2005) Supraspinatus Tendinosis Associated with Biceps Brachii Tendon Displacement in a Dog. Journal of the American Veterinary Medical Association, 227 (9), pp. 1429-1433.
  23. Chung, C.B. Gentili, A. and Chew, F.S. (2004) Calcific Tendinosis and Periarthritis: Classic Magnetic Resonance Imaging Appearance and Associated Findings. Journal of Computer Assisted Tomography 28 (3), pp. 390-396.
  24. Rupp, S. Seil, R. and Kohn, D. (2000) Tendinosis Calcarea of the Rotator Cuff. Orthopade, 29 (10), pp. 852-67.
  25. Kriegleder, H. (1995) Mineralization of the Supraspinatus Tendon: Clinical Observations in Seven Dogs. Veterinary and comparative orthopaedics and traumatology, 8, pp. 91-97.
  26. Muir, P. et al. (1996) Force-Plate Analysis of Gait before and after Surgical Excision of Calcified Lesion of the Supraspinatus Tendon in Two Dogs. Veterinary Record, 139 (6), pp. 137-139.
  27. Muir, P. and Johnson, K.A. (1994) Supraspinatus and Biceps Brachii Tendinopathy in Dogs. Journal of Small Animal Practice. 35 (5), pp. 239-243.
  28. Kunkel, K.A. and Rochat, M.C. (2008) A Review of Lameness Attributable to the Shoulder in the Dog: Part Two. Journal of the American Animal Hospital Association, 44 (4) pp. 163-170.
  29. Flo, G.L. and Middleton, D. (1990) Mineralization of the Supraspinatus Tendon in Dogs. Journal of the American Veterinary Medical Association, 197 (1) pp. 95-97.
  30. Laitinen, O.M. and Flor, G.L. (2000) Mineralization of the Supraspinatus Tendon in Dogs: A Long-Term Follow-Up. J Am Anim Hosp Assoc, 36 (3), pp. 262-267.
  31. Friedman, L. et al. (2002) Ultrasonography of the Shoulder: Pitfalls and Variants. Canadian Association of Radiologists Journal, 53(1), pp. 22-32.
  32. Jones, A.O. (1998) Magnetic Resonance Imaging of the Supraspinatus Tendon: The Significance of Signal Intensity Alterations at the Critical Zone. Australasian Radiology, 42 (2), pp. 106-113.
  33. Long, C.D. and Nyland, T.G. (1999) Ultrasonographic Evaluation of the Canine Shoulder. Veterinary Radiology & Ultrasound, 40 (4), pp. 372-379.
  34. Kramer, M. and Gerwing, M. (1996) The Importance of Sonography in Orthopaedics for Dogs. Berliner und Munchener Tierarztliche Wochenschrift, 109 (4), pp. 130-135.
  35. Kramer, M. et al. (2001) Ultrasonography for the Diagnosis of Diseases of the Tendon and Tendon Sheath of the Biceps Brachii Muscle. Veterinary Surgery, 30 (1), pp. 64-71.
  36. Mistieri, M.L. et al. (2012) Ultrasonographic Evaluation of Canine Supraspinatus Calcifying Tendinosis. Journal of the American Animal Hospital Association, 48 (6), pp. 405-410.
  37. Iannotti, J.P. et al. (2005) Accuracy of Office-Based Ultrasonography of the Shoulder for the Diagnosis of Rotator Cuff Tears. The Journal of Bone and Joint Surgery (American), 87 (6) pp. 1305-1311.
  38. Ottenheijm, R.P.G. et al. (2014) Ultrasound-Diagnosed Disorders in Shoulder Patients in Daily General Practice: A Retrospective Observational Study. BMC Family Practice, 15 (1) pp. 1115.
  39. Smith, T.O. et al. (2011) Diagnostic Accuracy of Ultrasound for Rotator Cuff Tears in Adults: A Systemic Review and Meta-Analysis. Clinical Radiology, 66 (11), pp. 1036-1048.
  40. Teefey, S.A. et al. (2004) Detection and Quantification of Rotator Cuff Tears. The Journal of Bone & Joint Surgery, 86 (4), pp. 708-716.
  41. Brose, S.W. et al. (2008) Shoulder Ultrasound Abnormalities, Physical Examination Findings, and Pain in Manual Wheelchair Users with Spinal Cord Injury. Archives of Physical Medicine and Rehabilitation, 89 (11) pp. 2086-2093.
  42. Danova, N.A. and Muir, P. (2003) Extracorporeal Shock Wave Therapy for Supraspinatus Calcifying Tendinopathy in Two Dogs. Veterinary Record, 152 (7), pp. 208-209.
  43. Benell, K. S. et al. (2007) Efficacy and Cost-Effectiveness of a Physiotherapy Program for Chronic Rotator Cuff Pathology: A Protocol for Randomized, Double-Blind, Placebo-Controlled Trial. BMC Musculoskeletal Disorders, 8 (1), pp. 86.
  44. Cookson, J.C. and Kent, B.E. (1979) Orthopaedic Manual Therapy, an Overview. Part 1. The Extremities. Physical Therapy, 59 (2), pp. 136-146.
  45. Devor, M. and Sorby, R. (2006) Fibrotic Contracture of the Canine Infraspinatus Muscle: Pathophysiology and Prevention by Early Surgical Intervention. Veterinary and Comparative Orthopaedics and Traumatology, 19, pp. 117-121.
  46. Kesikburun, S. et al. (2013) Platelet-Rich Plasma Injections in the Treatment of Chronic Rotator Cuff Tendinopathy: A Randomized Controlled Trial with 1-Year Follow Up. The American Journal of Sports Medicine, 41 (11), pp. 2609-2616
  47. Canapp, S.O. (2013) Regenerative Medicine for Tendinopathies in the Canine. In: Proceedings ACVS Symposium. San Antonio, TX 24 -26 April. American College of Veterinary Sports Medicine and Rehabilitation, pp. 343-347.
  48. Brosseau, L. et al. (2002) Deep Transverse Friction Massage for Treating Tendonitis. Cochrane Database System Reviews (4):CD003528.
  49. Wernham, B.G. Warman, G.A. and Jarram, R.M. (2008) Bicipital Tenosynovitis in Dogs. Compendium on Continuing Education for the Practising Veterinarian, 30 (10), pp. 537-552.
  50. Gilley, R.S. Wallace, L.J. and Hayden, D.W. (2002) Clinical and Pathologic Analyses of Bicipital Tenosynovitis in Dogs. American Journal of Veterinary Research, 63 (3), pp. 402-407.
  51. Jo, C.H. et al. (2011) Does Platelet-Rich Plasma Accelerate Recovery after Rotator Cuff Repair: A Prospective Cohort Study. The American Journal of Sports Medicine, 39 (10), pp. 2082-2090.

  • There are currently no refbacks.

Copyright (c) 2016 Sherman O Canapp, Debra A Canapp, Brittany Jean Carr, Catherine Cox, Jennifer G Barrett

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Made possible through a project grant from the RCVS Council.