56-year-old male with shoulder pain. Evaluate rotator cuff. ROTATOR CUFF: There is a near complete to complete tear of the supraspinatus tendon at the level of its insertion on the greater tuberosity with approximately 4 cm of retraction of the proximal tendon fragment. There is mild atrophy of the supraspinatus muscle. There is partial thickness tearing of the anterior fibers of the infraspinatus tendon. The infraspinatus muscle appears intact. The teres minor and subscapularis muscles and tendons appear intact. Note is made of metallic susceptibility artifact within the superolateral humeral head presumably representing postsurgical changes from prior rotator cuff repair.SUPRASPINATUS OUTLET: There is a moderate amount of fluid within the subacromial subdeltoid bursa. Intra-articular gadolinium extends into the subacromial subdeltoid bursa. Mild degenerative changes affect the acromioclavicular joint. Note is made of a high riding humeral head. GLENOHUMERAL JOINT AND GLENOID LABRUM: Note is made of a high riding humeral head. The glenohumeral joint alignment is anatomic. Moderate to severe degenerative changes affect the glenohumeral joint including osteophyte formation and articular cartilage degeneration. There is near full-thickness articular cartilage degeneration along the superior aspect of the humeral head as well as along the glenoid. There is heterogeneity and increased signal intensity within the superior posterior glenoid labrum which may reflect degeneration/tearing. No fluid-filled or gadolinium filled labral defects are identified.BICEPS TENDON: There is thickening and intermediate signal abnormality within the extra-articular portion of the long head of the biceps indicating tendinosis. There is an apparent longitudinal split tear of the intra-articular portion of the long head of the biceps tendon.ADDITIONAL
1. Near complete to complete tear of the supraspinatus tendon with retraction. Partial-thickness tearing of the infraspinatus tendon.2. Osteoarthritic changes of the glenohumeral joint.3. Findings consistent with a longitudinal split tear and tendinosis of the long head of the biceps. Other findings as described above.