Reason: Evaluate for rotator cuff tear. History of rotator cuff repair in 2003 with recent fall with concern for partial tear History: pain, decreased ROM ROTATOR CUFF: Evaluation of the rotator cuff is limited due to metallic susceptibility artifact from suture anchors within the humeral head as well as additional foci of susceptibility artifact within the soft tissues adjacent to the rotator cuff. The anterior fibers of the supraspinatus tendon are poorly defined. The distal 1 cm of the anterior fibers of the tendon are replaced with intermediate-high signal intensity that we suspect represents tendinosis, and although we see no frank fluid signal intensity traversing the tendon, we cannot exclude the possibility of a chronic tear filled with granulation tissue. There is also irregularity of the undersurface of the supraspinatus tendon indicating undersurface fraying and furthermore, the supraspinatus tendon is thinned, posteriorly, likely reflecting chronic attritional tearing. There is mild fatty atrophy of the supraspinatus at the level of the myotendinous junction. The infraspinatus tendon appears intact, although there is mild to moderate atrophy of the infraspinatus muscle. The teres minor and subscapularis muscles and tendons appear intact.SUPRASPINATUS OUTLET: Mild to moderate osteoarthritis affects the acromioclavicular joint. There is a trace amount of fluid within the subacromial/subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: The superior portion of the anterior labrum is not well visualized and the middle glenohumeral ligament is noted to be prominent. This may represent a normal variant Buford complex. Mild osteoarthritis affects the glenohumeral joint. BICEPS TENDON: There is mild tendinosis of the intra-articular portion of the long head of the biceps tendon.
1. Limited evaluation of the rotator cuff due to metallic susceptibility artifact showing chronic tendinosis and attritional tearing of the supraspinatus. We suspect that increased signal intensity within the anterior fibers of the supraspinatus represents tendinosis, as we see no fluid signal intensity traversing the tendon, nor do we see a large subdeltoid bursitis; however, we cannot exclude the possibility of a chronic full-thickness tear filled with granulation tissue. If further imaging is clinically warranted, MR arthrography could be considered.2. Mild osteoarthritis and other findings as described above.