Right shoulder pain, history of rotator cuff repair 12 years ago. Evaluate for rotator cuff arthropathy. Tubular foci of signal abnormality are noted in the humeral head extending to the greater tuberosity anteriorly and laterally presumably representing suture anchor tracks from prior rotator cuff repair.ROTATOR CUFF: There is a complete tear of the supraspinatus tendon with retraction to the glenohumeral joint. There is mild fatty atrophy of the supraspinatus muscle. This tear extends posteriorly to involve the majority of the infraspinatus tendon, although there are perhaps a few posterior fibers that extend to the greater tuberosity. There is severe fatty atrophy of the infraspinatus muscle. The teres minor muscle and tendon are intact. There is also tendinosis and interstitial tearing of the subscapularis tendon, although we are not convinced that there is a full-thickness tear. There is mild atrophy of the superior portion of the subscapularis muscle.SUPRASPINATUS OUTLET: Moderate osteoarthritis affects the acromioclavicular joint. There is a mild deformity that likely represents a combination of prior surgery and osteoarthritis. There is a small amount of fluid in the subacromial space as a result of the patient's large rotator cuff tear. Little if any fluid is present in the subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: There is elevation of the humeral head with narrowing of the acromiohumeral interval to 1 to 2 mm. There is mild acetabularization of the acromion as well as mild subchondral sclerosis along the superior aspect of the humeral head. Moderate to severe osteoarthritis affects the glenohumeral joint with portions of the glenoid appearing to be devoid of articular cartilage. There is heterogeneity of the glenoid labrum circumferentially likely representing degenerative tearing. A small amount of fluid is present in the glenohumeral joint. Intermediate signal intensity in the axillary recess likely represents synovitis.BICEPS TENDON: The tendon of the long head of the biceps is not well visualized in the bicipital groove nor within the rotator interval and we suspect it is ruptured.
Large rotator cuff tear and associated moderate to severe osteoarthritis of the shoulder with other findings as above.