Rotator cuff injury, limited range of motion. ROTATOR CUFF: Supraspinatus/infraspinatus-There is mild intermediate signal intensity within the supraspinatus tendon and anterior portion of the infraspinatus tendon indicating tendinosis and perhaps mild interstitial tearing. No full-thickness fluid-filled rotator cuff tear is identified. Muscle bulk and signal of the infraspinatus and supraspinatus muscles are within normal limits. The teres minor tendon is intact and the muscle demonstrates normal bulk and signal intensity. There is a hypointense focus immediately anterior to the lesser tuberosity with surrounding edema. Edema appears to involve the distal fibers of the subscapularis tendon. Additionally, there is thickening of the subscapularis tendon which could in part reflect redundancy of the tendon as the patient's arm is held in internal rotation. The 'transverse ligament' component of the subscapularis tendon is not well visualized.SUPRASPINATUS OUTLET: AC joint and acromiohumeral intervals are maintained. There is trace fluid in the subacromial subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: Glenohumeral alignment is maintained. Small amount of fluid in the glenohumeral joint. The labrum is intact, given limitations of a non-arthrogram exam.BICEPS TENDON: The intra and extra-articular portions of the biceps tendon are within normal limits ADDITIONAL
1. Abnormal signal intensity of the distal fibers of the subscapularis tendon and adjacent soft tissues with moderate edema. This could represent an insertional subscapularis tendon injury if there is a recent history of trauma. However, a focus of low signal intensity seen anterior to the lesser tuberosity raises the possibility of calcium hydroxyapatite deposition with surrounding inflammation (calcific tendinopathy). Radiographs of the shoulder, including an axillary view, are recommended for further evaluation.2. Edema of the subcutaneous fat anterior to the deltoid muscle may reflect sequelae of recent intervention such as injection, or contusion. Other findings as above.