Shoulder pain and difficulty with external rotation ROTATOR CUFF: There is increased signal and thickening of both the infra- and supraspinatus tendons consistent with moderate tendinosis. At the junction of the superior and infraspinatus tendons is a 1 cm linear focus of increased signal intensity at the rotator cuff insertion indicating an interstitial tear. This tear does not appear to extend to either articular surface. A small degenerative cyst is seen in the underlying greater tuberosity.More posteriorly, there is longitudinal signal intensity extending longitudinally along the myotendinous junction of the infraspinatus tendon representing an additional interstitial tear. The tear measures 1.5 cm in the longitudinal dimension and there is no definite extension to the bursal surface.Evaluation of the subscapularis tendon is somewhat limited by internal rotation. The distal fibers of the subscapularis tendon also demonstrate thickening and increased signal, consistent with tendinosis.The teres minor tendon appears normal.The muscles of the rotator cuff are normal. SUPRASPINATUS OUTLET: An os acromiale is present and there are mild osteoarthritic changes of the acromioclavicular joint. There is no subacromial/subdeltoid fluid however there is mild impression of the acromium upon the superior fibers of the supraspinatus muscle at the level of the distal clavicle.GLENOHUMERAL JOINT AND GLENOID LABRUM: A trace amount of fluid is noted in the glenohumeral joint but there is no large joint effusion. There are mild osteoarthritic changes of the glenohumeral joint including subchondral cystic changes of the anterior glenoid. There is abnormal signal within the labrum both anteriorly and posteriorly suggesting degenerative tearing. There is additional fraying of the superior labrum. There is intermediate signal within the subscapularis recess which may reflect a component of synovitis.BICEPS TENDON: Evaluation of the biceps is slightly limited due to internal rotation. The intra-articular portion of the long head tendon of the biceps is enlarged and increased in signal consistent with moderate tendinosis. A small focus of intermediate signal is noted along the extra-articular biceps which may reflect a small cartilaginous fragment.
1. Moderate rotator cuff tendinosis with interstitial tearing further detailed above. No definite full-thickness tear is seen.2. Osteoarthritis of the glenohumeral and acromioclavicular joint.3. Moderate biceps tendinosis.