Left shoulder pain ROTATOR CUFF: There is increased signal intensity throughout much of the supraspinatus tendon indicating moderate tendinosis. Furthermore, there is disruption of the articular and bursal surface fibers of the tendon indicating at least partial-thickness tearing of the distal 1.5 cm of the tendon with perhaps a network of full-thickness tearing; however we see no discrete fluid-filled gap or frank tendon retraction. The supraspinatus muscle is normal. The tendinosis and surface tearing extends posteriorly to involve the anterior portion of the infraspinatus tendon; however more posteriorly, the infraspinatus tendon is intact. Small cysts are identified within the greater tuberosity which are likely degenerative in nature. There is mild fatty infiltration along the myotendinous junction of the infraspinatus tendon but the muscle is otherwise normal. Although the teres minor tendon is intact, there is mild to moderate diffuse fatty atrophy of the teres minor muscle which is of uncertain etiology. A small (6 mm) linear focus of fluid signal intensity of the subscapularis tendon is seen at its insertion which represents a small focal tear that appears to involve the majority of the thickness of the tendon; this is of questionable clinical significance. The subscapularis muscle is normal. SUPRASPINATUS OUTLET: There is moderate osteoarthritis of the acromioclavicular joint with the distal clavicle appearing enlarged, possibly representing an old healed fracture; there is mild impression upon the superior fibers of the supraspinatus. A small amount of fluid is present within the subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: Alignment of the glenohumeral joint is normal and there is no joint effusion. There is linear increased signal intensity traversing the anterior superior labrum which may represent a tear or normal variant sublabral foramen. The remainder of the labrum is normal within the limits of a non-arthrogram study.BICEPS TENDON: There is a small amount of fluid within the biceps tendon sheath likely representing mild tenosynovitis given the lack of fluid within the joint space. The biceps tendon otherwise appears normal.
1. Increased signal throughout much of the supraspinatus tendon extending to involve the anterior fibers of infraspinatus tendon which reflects a combination of moderate tendinosis and surface tearing. We cannot exclude the possibility of a network of tears creating a full-thickness defect but we see no fluid-filled gap or frank tendinous retraction. There is also a small focal insertional tear of the subscapularis.2. Moderate osteoarthritis of the acromioclavicular joint with mild enlargement/deformity of the distal clavicle which may represent a remote healed fracture.3. Additional findings described above.