Male, 69 years old. Pain. Evaluate for rotator cuff tear. Several sequences are limited by patient motion artifact. Multiple foci of signal void are noted in the soft tissues above the humeral head presumably representing metallic susceptibility artifact from prior surgery.ROTATOR CUFF: There is a full-thickness tear of the supraspinatus tendon with approximately 1 cm of proximal retraction. The tear involves the majority of the supraspinatus tendon, although a small portion of the tendon posteriorly appears to extend to the greater tuberosity. The remainder of the supraspinatus tendon appears thinned, likely reflecting chronic attritional tearing. There is mild fatty atrophy along the myotendinous junction. Otherwise, the supraspinatus muscle appears normal. Mild tendinosis affects the infraspinatus tendon, but we see no full-thickness tear. There is mild fatty atrophy of the infraspinatus muscle. The teres minor muscle and tendon are intact. There is increased signal intensity in the subscapularis tendon distally indicating moderate to severe tendinosis and interstitial tearing with propagation of tearing along the myotendinous junction and formation of a small intramuscular cyst. Small cysts are seen in the underlying lesser tuberosity. The subscapularis muscle appears intact. The coracohumeral interval is approximately 7 mm, raising the possibility of subcoracoid impingement.SUPRASPINATUS OUTLET: There is widening of the acromioclavicular joint presumably reflecting prior surgery. There is fluid in the subacromial/subdeltoid bursa, likely reflecting the patient's rotator cuff tear. The coracoacromial ligament appears slightly thickened.GLENOHUMERAL JOINT AND GLENOID LABRUM: There is perhaps mild osteoarthritis of the glenohumeral joint. Intermediate signal intensity within the superior labrum suggests degeneration, but we see no fluid-filled labral tear. There is a small glenohumeral joint effusion with fluid concentrating in the subscapular recess.BICEPS TENDON: Although the tendon of the long head of the biceps is visualized within the bicipital groove, it is not visualized in the rotator interval, which may reflect rupture or prior tenotomy.
1.Full-thickness near-complete tear of the supraspinatus tendon with additional rotator cuff tendinopathy as described above.2.Surgical changes of acromioclavicular joint resection as above.3.Degeneration of the superior labrum with nonvisualization of the intra-articular biceps tendon, presumably reflecting rupture or prior tenotomy.