The supraspinatus is a relatively small muscle of the upper back that runs from the supraspinatus fossa superior portion of the scapula to the greater tubercle of the humerus. It is one of the four rotator cuff muscles and also abducts the arm at the shoulder. A supraspinatus tear is a tear or rupture of the tendon of the supraspinatus muscle.

Many pathological conditions as trauma (whether acute or chronic), inflammation or instability may cause supraspinatus muscle disease which is one of the commonest cause of shoulder pain and malfunction.

Supraspinatus muscle failure usually results from tendinopathy that transforms from partial to full thickness tears.

Basically shoulder impingement is a clinical diagnosis. The role of imaging in such condition is to identify the causal factors as well as to detect the involvement of tendon injuries and its extension as tears of the cuff muscles is difficult to be identified clinically.

The decision making in the treatment of the supraspinatus muscle tears relies mainly upon the correct diagnosis of the type and extent of the tear. According to the diagnosis whether conservative or surgical treatment is chosen, even the type of the surgical intervention (open or arthroscopic) would differ according to the diagnosis.

In addition identifying the extent of tendons retraction and the condition of the ruptured edges, as well as the quality of the muscle itself influences the management policy.

To evaluate the painful shoulder a variety of imaging tests have been used; yet, for diagnosing a supraspinatus muscle tear the standard imaging modalities such as unenhanced magnetic resonance imaging, indirect and direct magnetic resonant arthrography, and ultrasound are used.

US of the shoulder is utilized increasingly in healthcare settings to assess the integrity of the supraspinatus muscle. It is a non-invasive examination with practically no side effects. It is beneficial in the dynamic examination of the tendon during movement of the shoulder .

Inclusion Criteria:

• patients of different age groups presented with clinical diagnosis department of shoulder impingement and diagnosed by magnetic resonance imaging as supraspinatus

Exclusion Criteria:

• patients with previous shoulder surgery

Patients of different age groups presented with clinical diagnosis of shoulder impingement