Reason: Right shoulder dislocations over the past 2 months, history of multiple myeloma tx'd at outside hospital, now with acromial mass and lesion in proximal humerus and scapula, evaluate for cause of instability History: above ROTATOR CUFF: There is a high-grade partial-thickness tear of the bursal surface fibers of the supraspinatus tendon at the level of its insertion on the greater tuberosity without significant retraction, measuring approximately 15 mm in the AP dimension. There is interstitial tearing of the infraspinatus at the level of the myotendinous junction. There is interstitial tearing of the subscapularis at the level of the myotendinous junction. The teres minor muscle and tendon appear intact. There are intramuscular cysts within the muscle belly of the subscapularis.SUPRASPINATUS OUTLET: There is no significant fluid within the subacromial subdeltoid bursa. Mild osteoarthritis affects the acromioclavicular joint.GLENOHUMERAL JOINT AND GLENOID LABRUM: The glenohumeral joint alignment is anatomic. There is heterogeneity and increased signal intensity within the superior, anterior, and inferior labrum suggesting degeneration/degenerative tearing. No fluid-filled tear is evident on this non arthrogram study.BICEPS TENDON: The tendon of the long head of the biceps appears intact. ADDITIONAL
1. Findings consistent with the stated history of multiple myeloma as described above.2. Avascular necrosis of the humeral head.3. High-grade partial-thickness tearing of the supraspinatus as well as additional interstitial tearing of the rotator cuff without significant retraction.4. Glenoid labral degeneration/degenerative tearing.