63-year-old female with severe shoulder pain and bacteremia. Evaluate for septic arthritis of the shoulder. ROTATOR CUFF: There is increased signal abnormality within the supraspinatus, infraspinatus, and teres minor muscles as well as within the subscapularis muscle, suspicious for pyomyositis given the stated history of bacteremia. There is thickening and increased signal abnormality of the supraspinatus tendon consistent with moderate tendinosis. Note is made of a full-thickness tear of the supraspinatus tendon approximately 7 mm of retraction. There is also partial thickness tearing of the anterior fibers of the infraspinatus tendon.SUPRASPINATUS OUTLET: Degenerative changes affect the acromioclavicular joint. There is a small amount of fluid within the acromioclavicular joint.GLENOHUMERAL JOINT AND GLENOID LABRUM: There is a moderate sized glenohumeral joint effusion. Although this examination was not protocol for examination of the glenoid labrum, there appears to be increased linear signal abnormality traversing the posterosuperior glenoid labrum suspicious for degenerative tearing.BICEPS TENDON: There is a small amount of circumferential fluid within the tendon sheath of the long head of the biceps which may represent fluid extension from the glenohumeral joint. ADDITIONAL
Findings consistent with pyomyositis/soft tissue infection most pronounced along the anterior aspect of the shoulder with associated abscess formation and glenohumeral joint effusion, raising the question of septic arthritis.