Severe right shoulder pain The exam is limited by motion artifact and by the patient's body habitus which prevented the use of an optimal shoulder coil.ROTATOR CUFF: There is thickening and increased signal intensity the supraspinatus tendon indicating moderate tendinosis. There is a 5 mm tear involving the insertional fibers of the anterior supraspinatus tendon which may focally disrupt the bursal surface fibers but this is equivocal. The articular surface fibers appear spared. There is an additional 4 mm tear within the supraspinatus tendon more proximally at the 12:00 position which may also focally disrupt the bursal surface fibers but again this is equivocal. The supraspinatus muscle is normal in signal and caliber.The above-mentioned tendinosis of the supraspinatus extends posteriorly to affect the anterior fibers of the infraspinatus tendon but we see no discrete tear of the infraspinatus tendon. The infraspinatus muscle is normal in signal and caliber. The teres minor tendon and muscle are normal. Small cysts are noted on the humeral head at the insertion of the teres minor which are of doubtful clinical significance. There is increased signal intensity of the distal fibers of the subscapularis tendon indicating insertional tendinosis. There is perhaps minimal fatty atrophy of the subscapularis muscle.SUPRASPINATUS OUTLET: Mild osteoarthritis affects the acromioclavicular joint. There is more focal edema of the distal clavicle which may be degenerative in nature but could also represent a stress fracture in the appropriate clinical context.GLENOHUMERAL JOINT AND GLENOID LABRUM: The anterior labrum appears attenuated suggesting degenerative tearing. Alignment of the glenohumeral joint is normal and there is no joint effusion.BICEPS TENDON: Evaluation of the intra-articular portion of the biceps tendon is limited by internal rotation; however within the limits of a non-arthrographic study, the biceps appears intact.
1. Moderate rotator cuff tendinosis with small focal partial-thickness tears of the supraspinatus tendon that may disrupt the bursal surface fibers.2. Mild osteoarthritis of the acromioclavicular joint with more focal edema of the distal clavicle which may be degenerative in nature but could also represent a stress fracture in the appropriate clinical context.3. Additional findings described above.