Reason: Assess for rotator cuff tear - concern for supraspinatus and infraspinatus; acute injury 5/15 with new weakness and shoulder pain History: Right shoulder pain, supraspinatus and infraspinatus weakness after acute injury (fall) ROTATOR CUFF: Again seen is a full-thickness tear of the anterior fibers of the supraspinatus at the level of its insertion on the greater tuberosity measuring approximately 2.2 cm in the AP dimension. There is associated retraction of the proximal tendon fragment by approximately 4 cm. There is thickening and intermediate signal intensity within the proximal tendon fragment indicating tendinosis. There is moderate fatty atrophy of the supraspinatus. The infraspinatus muscle and tendon appear intact. There is thickening and intermediate signal intensity within the subscapularis indicating moderate tendinosis. There is linear fluid signal intensity within the tendon indicating interstitial tearing. The teres minor muscle and tendon appear intact.SUPRASPINATUS OUTLET: There is a small amount of fluid within the subacromial subdeltoid bursa with foci of low signal intensity internally which may reflect a bursitis or debris. Severe osteoarthritis affects the acromioclavicular joint.GLENOHUMERAL JOINT AND GLENOID LABRUM: The glenohumeral joint alignment is anatomic. There is heterogeneity and increased signal abnormality within the inferior labrum likely representing a combination of degeneration and degenerative tearing.BICEPS TENDON: There is a small amount of fluid within the tendon sheath of the long head of biceps tendon which may represent fluid extension from the joint. The tendon itself appears intact. ADDITIONAL
1. Full-thickness tear of the anterior fibers of the supraspinatus with retraction which appears increased in size when compared to the prior study. Interstitial tearing of the subscapularis. Rotator cuff tendinosis.2. Osteoarthritis of the shoulder.3. Findings suggestive of a subacromial subdeltoid bursitis and possible glenohumeral joint synovitis. Other findings as described above.