52-year-old female with pain and weakness. Evaluate post rotator cuff repair one year ago. Evaluation of the greater tuberosity and adjacent soft tissue is limited due to metallic susceptibility artifact from orthopedic hardware.ROTATOR CUFF: At the 12:00 position, a thin supraspinatus tendon can be followed from the myotendinous junction to the greater tuberosity at the vicinity of aforementioned orthopedic hardware. This intact portion of the tendon measures approximately 1.5 to 2 cm in AP dimension. We suspect that there is delamination of the undersurface fibers of the supraspinatus with retraction to the level of the glenohumeral joint, but this may represent pre-existing undersurface tearing rather than postoperative tearing. There is a fluid-filled gap along the anterior margin of the remaining supraspinatus tendon insertion compatible with a full-thickness tear of the anterior fibers of the supraspinatus, but again we are uncertain if this represents a pre-existing tear or tear which occurred following surgery. There is mild atrophy of the supraspinatus muscle. The infraspinatus muscle and tendon appear intact, although there is perhaps mild fatty infiltration along the myotendinous junction. The teres minor muscle and tendon appear intact. Subscapularis muscle and tendon appear intact.SUPRASPINATUS OUTLET: There is mild widening of the acromioclavicular joint indicating prior surgery. There is a small amount of fluid within the subacromial bursa. There is anterior spurring of the acromion process.GLENOHUMERAL JOINT AND GLENOID LABRUM: The glenohumeral joint alignment is within normal limits. We see no evidence of joint effusion. Branching intermediate signal intensity within the superior labrum as well as attenuation of the posterior labrum may reflect degenerative tearing.BICEPS TENDON: The biceps tendon is noted anterior to the proximal humeral diaphysis but this disappears within the bicipital groove, presumably representing prior tenotomy.
1. Fibers of the thinned supraspinatus tendon can be traced to their insertion on the greater tuberosity. There appears to be delamination of the undersurface fibers of the supraspinatus tendon, with retraction proximally, as well as full-thickness tearing of the anterior most fibers of the tendon. However, we cannot state with certainty if this represents pre-existing tearing or tearing that is occurred since surgery.2. Postoperative changes of the greater tuberosity, acromioclavicular joint, and biceps tendon as described above.3. Degeneration of the glenoid labrum.