Female, 57 years old. Right shoulder pain, continued pain despite injections and physical therapy, evaluate for rotator cuff tear. ROTATOR CUFF: There is a full-thickness near-complete to complete tear of the supraspinatus tendon with retraction of the tendon to the level of the glenohumeral joint. There is moderate atrophy of the supraspinatus muscle. There may be mild degeneration and/or fraying of the anterior fibers of the infraspinatus tendon, but the majority of the tendon appears to extend to the greater tuberosity. Mild increased signal intensity within the tendon suggests tendinosis. The infraspinatus muscle appears normal. The teres minor muscle and tendon appear normal. There is thickening and increased signal intensity within the distal subscapularis tendon indicating moderate tendinosis with additional linear foci of high signal intensity at its insertion indicating partial thickness insertional tearing. The subscapularis muscle appears normal. Small cysts are noted in the greater and lesser tuberosities likely reflecting the aforementioned rotator cuff pathology.SUPRASPINATUS OUTLET: Mild osteoarthritis affects the acromioclavicular joint with a small amount of fluid in the joint.GLENOHUMERAL JOINT AND GLENOID LABRUM: Glenohumeral joint alignment is normal. There is increased signal intensity within the superior labrum suggestive of tearing. The inferior labrum appears intact. There is a small amount of fluid in the glenohumeral joint but no large effusion.BICEPS TENDON: There is increased signal intensity within the biceps tendon particularly at its transition from the rotator interval to the intertubercular groove indicating moderate tendinosis and partial-thickness tearing.
1.Near-complete/complete tear of the supraspinatus with retraction and additional rotator cuff pathology as described above.2.Osteoarthritis of the acromioclavicular joint.3.Tendinosis and partial-thickness tearing of the tendon of the long head of the biceps and other findings as above.