Evaluate for partial thickness rotator cuff tear given mechanical trauma to shoulder during fall two years ago with residual weakness and positive physical exam findings for rotator cuff weakness. ROTATOR CUFF: There is a complete tear of the supraspinatus tendon with retraction to the level of the glenohumeral joint. There is mild atrophy and fatty infiltration of the supraspinatus muscle. There is also a near-complete/complete tear of the infraspinatus tendon with similar retraction. There is moderate to severe atrophy of the infraspinatus muscle. The teres minor muscle and tendon appear intact. Although the inferior fibers of the subscapularis tendon can be followed to their humeral insertion, more superiorly the fibers are largely replaced with intermediate signal intensity likely representing a combination of severe tendinosis and insertional tearing. The subscapularis muscle appears normal.SUPRASPINATUS OUTLET: Moderate osteoarthritis affects the acromioclavicular joint. The humeral head is high riding with the acromiohumeral interval measuring 2 mm at its most narrowed point.GLENOHUMERAL JOINT AND GLENOID LABRUM: Mild osteoarthritis affects the glenohumeral joint. There is tearing of the superior labrum that extends inferiorly into the anterior labrum. There is a small amount of fluid in the joint, but I see no large effusion.BICEPS TENDON: There is increased signal intensity within the tendon of long head of the biceps at its transition from the rotator interval to the intertubercular groove indicating focal tendinosis and possibly partial thickness tearing. A small amount of fluid within the biceps tendon sheath may reflect a mild tenosynovitis.
1.Full-thickness retracted tears of the supraspinatus and infraspinatus tendons, with severe tendinosis and insertional tearing of the subscapularis tendon as described above.2.Osteoarthritis as described above.3.Labral tearing and biceps tendinosis as described above.