Reason: evaluate for etiology of Left shoulder pain History: Left shoulder pain after fall on ice ROTATOR CUFF: There is thickening and increased signal intensity affecting the supraspinatus and infraspinatus tendons indicating moderate tendinosis. There is more focal increased signal intensity within the posterior fibers of the supraspinatus at approximately the 12 o'clock position, 1 cm proximal to the tendon insertion, extending from the bursal surface fibers across the majority of the tendon thickness towards the articular surface fibers, measuring approximately 7 to 8 mm in AP dimension. The signal intensity is not as high as fluid and it is therefore possible that this could represent a more focal manifestation of the patient's tendinosis, however, we cannot exclude the possibility of a near full-thickness tear partially filled with granulation tissue or blood. There is mild increased signal intensity more proximally along the myotendinous junction of the supraspinatus which could represent a strain injury. There is thin fluid signal intensity along the myotendinous junction of the infraspinatus suggesting interstitial tearing. The teres minor and subscapularis tendons and muscles appear intact.SUPRASPINATUS OUTLET: Mild osteoarthritis affects the acromioclavicular joint. There is a small amount of fluid within the subacromial bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: There is a small glenohumeral joint effusion. There is minimal posterior translation of the humeral head relative to the glenoid, but no frank dislocation. The anterior inferior labrum appears unusually prominent and is perhaps partially detached from the underlying glenoid. The superior and posterior labrum appear attenuated, but this may reflect normal anatomy for this patient.BICEPS TENDON: There is fluid within the tendon sheath of the long head of the biceps which may represent fluid extension from the joint. ADDITIONAL
1. Rotator cuff tendinosis and interstitial tearing as described above. Although we see no full-thickness fluid-filled rotator cuff tear, there is focal increased signal intensity within the posterior fibers of the supraspinatus tendon which could represent a near full-thickness tear involving the bursal surface fibers that is not of fluid signal intensity due to granulation tissue or blood products.2. Deformity of the anterior inferior labrum could represent a tear, particularly if there is a history of prior dislocation.3. Other findings as described above.