Reason: Concern for rotator cuff tear History: Limited ROM, trauma ROTATOR CUFF: The distal 6 to 7 mm of the supraspinatus tendon is replaced with intermediate signal intensity. This could either represent insertional tendinosis or a high-grade partial-thickness insertional tear that has filled with granulation tissue. This intermediate signal intensity extends in the AP dimension for just over 1 cm. More proximally, there is a focus of high signal intensity along the undersurface fibers of the supraspinatus tendon indicating a small articular surface tear, measuring approximately 5 mm in diameter and involving less than 50% of the tendon thickness. There is additional tendinosis along the myotendinous junction of the supraspinatus more proximally. Additionally, there is a small focus of low signal intensity within the distal fibers of the supraspinatus tendon with mild edema within the adjacent soft tissues raising the possibility of calcific tendinosis. This could be better evaluated with dedicated shoulder radiographs. The infraspinatus and teres minor muscles and tendons appear intact. The subscapularis muscle and tendon appear intact.SUPRASPINATUS OUTLET: Mild to moderate osteoarthritis affects the acromioclavicular joint. There is slight lateral downsloping and lateral spurring of the acromion process. There is minimal, if any, fluid within the subacromial/subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: The glenohumeral joint alignment is within normal limits. There is no effusion. There is increased signal intensity within the anterior superior labrum which may reflect tearing, but this is of questionable clinical significance.BICEPS TENDON: The tendon of the long head of the biceps appears intact. ADDITIONAL
1. Tendinosis and focal undersurface tearing of the supraspinatus tendon. There is additional intermediate signal intensity within the distal most fibers of the tendon which may represent insertional tendinosis, although we cannot exclude the possibility of a high-grade partial-thickness tear that has filled with granulation tissue. Furthermore, there is a focus of low signal intensity within the distal supraspinatus tendon with adjacent soft tissue edema which raises the possibility of calcific tendinosis and would be better evaluated with shoulder radiographs.2. Osteoarthritis of the acromioclavicular joint and other findings as described above.