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supraspinous fossa of scapula

The supraspinous fossa of the scapula is the shallow concavity located on the posterior surface of the scapula, above the spine of the scapula. It is smaller than the infraspinous fossa and is separated from it by the scapular spine. The fossa extends laterally to the glenoid process and medially toward the vertebral border of the scapula.

The supraspinatus muscle originates from the supraspinous fossa and passes laterally through the suprascapular notch to insert on the greater tubercle of the humerus. This muscle plays a crucial role in shoulder abduction and stabilization of the glenohumeral joint. The fossa is covered by supraspinous fascia, which completes the osseofibrous compartment for the supraspinatus muscle.

Clinically, the supraspinous fossa is significant in rotator cuff pathology, especially supraspinatus tendon tears, suprascapular nerve entrapment, and muscle atrophy. On imaging, it is a key site to evaluate fatty infiltration, edema, and mass lesions.

Synonyms

  • Supraspinatus fossa

  • Fossa supraspinata scapulae

Function

  • Provides origin for the supraspinatus muscle (part of the rotator cuff)

  • Supports shoulder abduction and stability through supraspinatus function

  • Serves as an anatomical compartment for neurovascular passage (via suprascapular notch)

  • Clinical landmark for nerve entrapment, rotator cuff disease, and muscle atrophy

MRI Appearance

T1-weighted images:

  • Fossa filled with supraspinatus muscle, which appears as intermediate signal intensity

  • Fatty infiltration in chronic rotator cuff tears appears as high signal intensity

T2-weighted images:

  • Normal muscle: intermediate signal

  • Muscle edema: hyperintense signal within the supraspinous fossa

  • Tumors or cystic lesions also appear bright relative to muscle

PD-FS (Proton Density Fat-Suppressed):

  • Excellent for detecting muscle edema, tendinopathy, and subtle tears

  • Fat is suppressed, highlighting pathology as hyperintense regions within the muscle or fascia

STIR:

  • Enhances visualization of muscle edema, inflammation, or denervation changes

  • Differentiates between fat infiltration (T1 bright, STIR dark) and true edema (STIR bright)

T1 Post-Gadolinium:

  • Enhances neoplastic, inflammatory, or vascular lesions within the fossa

  • Muscle itself does not enhance significantly unless pathological

MRI Non-Contrast 3D Imaging:

  • Allows 3D reconstruction of scapula, supraspinous fossa, and supraspinatus muscle

  • Useful for pre-surgical mapping in tumors, cysts, or nerve decompression

CT Appearance

Non-contrast CT:

  • Clearly demonstrates the bony outline of the supraspinous fossa and scapular spine

  • Detects fractures, cortical irregularities, and bony lesions

CT Post-Contrast:

  • Useful for evaluating enhancing soft tissue lesions, tumors, or vascular abnormalities within or adjacent to the fossa

  • 3D reconstructions provide detailed mapping for surgical planning

CT image

supraspinous fossa of scapula CT sag image -img-00000-00000

MRI images

supraspinous fossa of scapula MRI sag image

CT VRT 3D image

Supraspinous fossa of scapula 3d image