Reason: internal derangement resulted from recurrent right shoulder dislocation with possible Hill Sachs lesion on fluoroscopy, history of EDS, frequent dislocations History: difficulty with raising shoulder, pain ROTATOR CUFF: Note is made of partial thickness tearing of the bursal surface supraspinatus just proximal to the level of its insertion on the greater tuberosity measuring approximately 4 mm in the AP dimension. There is no significant retraction. There is thinning of the supraspinatus tendon likely representing chronic attritional tearing. There is partial thickness undersurface tearing of the subscapularis at the level of its insertion on the lesser tuberosity involving less than 50% of the tendon width. There is no significant retraction. The teres minor and infraspinatus muscles and tendons appear intact.SUPRASPINATUS OUTLET: There is a trace amount of fluid within the subacromial subdeltoid bursa. The acromioclavicular joint is normal in appearance.GLENOHUMERAL JOINT AND GLENOID LABRUM: There is slight posterior translation of the humeral head relative to the glenoid. There is deformity of the anterior humeral head which may reflect a reverse Hill Sachs impaction fracture deformity. Evaluation for labral tears is limited on this non arthrogram examination. However, there is a subcentimeter focus of fluid signal intensity along the posterior aspect of the inferior labrum which likely represents paralabral cyst formation, indicating a tear. There is articular cartilage degeneration along the posterior aspect of the glenoid. There is linear increased signal abnormality traversing the superior glenoid labrum which may represent a normal variant sublabral recess versus a superior labral tear.BICEPS TENDON: Evaluation of the tendon of the long head of the biceps is limited secondary to extensive susceptibility artifact from prior surgery and patient motion artifact.ADDITIONAL
1. Postsurgical changes of prior rotator cuff repair with partial thickness bursal surface as well as chronic attritional tearing of the supraspinatus as described above. No full-thickness rotator cuff tear or retraction is identified. Partial-thickness tearing of the subscapularis as described above.2. Findings suggestive of a reverse Hill Sachs impaction fracture deformity of the humerus with probable labral tears, within the limitations of this non arthrogram study. These findings may represent the sequelae of prior posterior dislocation. This could be further evaluated with a dedicated arthrogram MRI examination if clinically warranted.