Reason: left shoulder pain not responding to PT, please evaluate for pathology History: left shoulder pain ROTATOR CUFF: There is intermediate signal intensity along the bursal surface fibers of the supraspinatus at its insertion which may reflect tendinosis and/or fraying, but we see no fluid-filled tear. The supraspinatus muscle appears intact. There is perhaps minimal infraspinatus tendinosis as well, but we see no tear. The infraspinatus muscle appears intact. The subscapularis muscle and tendon appear intact. There is a small defect in the underlying humeral head which may be degenerative in etiology. The teres minor muscle and tendon appear intact.SUPRASPINATUS OUTLET: Minimal osteoarthritis affects the acromioclavicular joint. There is no frank fluid within the subacromial/subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: The glenohumeral joint alignment is anatomic. There is intermediate signal intensity within the superior labrum, but we are uncertain if this represents prominent undercutting of the articular cartilage or a SLAP tear. This is not necessarily of any clinical significance.BICEPS TENDON: Two low signal intensity structures are noted within the bicipital groove. While it is possible this could represent a longitudinal split tear of the tendon of the long head of the biceps, we suspect that this is a normal variant accessory tendon, as the intra-articular portion of the tendon of the long head of the biceps appears normal. There is a small amount of fluid within the tendon sheath which is not necessarily of any clinical significance.ADDITIONAL
1. Very mild tendinosis and partial thickness bursal surface fraying of the rotator cuff as described above. We see no full-thickness rotator cuff tear.2. Minimal osteoarthritis of the acromioclavicular joint.3. Equivocal tear of the superior labrum and probable normal variant accessory biceps tendon. These findings are not necessarily of any clinical significance, but could be further evaluated with MR arthrography if clinically warranted.