43-year-old male status post right shoulder injury now with decreased range of motion and pain, clinical concern for rotator cuff tear. ROTATOR CUFF: There is minimal intermediate signal in the distal fibers of the supraspinatus tendon and perhaps minimal undersurface tearing. We see no discrete tear. Similarly, there is mild irregularity of the undersurface fibers of the infraspinatus tendon, but we see no discrete tearing. The tendons of teres minor and subscapularis are intact. The musculature of the rotator cuff is intact.SUPRASPINATUS OUTLET: There is moderate osteoarthritis of the acromioclavicular joint. The distal end of the clavicle is enlarged, perhaps reflecting old trauma, with impression upon the superior fibers of supraspinatus. GLENOHUMERAL JOINT AND GLENOID LABRUM: Alignment of the glenohumeral joint is intact. As seen on the prior radiograph, there is a Bankart fracture of the anterior-inferior glenoid. We estimate the fracture fragment to be approximately 1.5 cm in greatest dimension and approximately 6 mm in width. It is difficult to assess the degree of glenoid bone loss on this study, but we estimate the loss to be between 10 and 15%.There is a moderate-sized joint effusion. There is a 2 cm crescentic bone/cartilaginous fragment is in the joint, representing a displaced fracture fragment from the posterior aspect of the humeral head, with edema of the underlying humeral head. There is an additional 6 mm focus of indeterminate signal in the posterior aspect of the glenohumeral joint, likely representing a bone or cartilage fragment.There is a bucket-handle type tear of the superior labrum, which extends into both the anterior and posterior labrum. The cartilage of the anterior aspect of the glenohumeral joint appears thinned with full-thickness cartilage loss along the inferior aspect of the glenoid.BICEPS TENDON: The tendon of the long head of the biceps appears thin at its anchor, and may represent extension of the SLAP tear. The remaining biceps tendon appears intact. Fluid within the bicipital sheath likely represents extension from the glenohumeral joint effusion.
1.Findings compatible with prior anterior shoulder dislocation, with associated Bankart fracture and a displaced osteochondral fragment from the posterior lateral aspect of the humeral head into the glenohumeral joint.2.Labral tearing with a equivocal extension into the biceps anchor as described above.3.Moderate osteoarthritis of the acromioclavicular joint.4.Cartilage loss along the inferior glenoid.5.Minimal tendinosis and perhaps minimal undersurface fraying of the rotator cuff.