New shoulder and upper arm pain. Rotator cuff tear? Multiple foci of signal void within the soft tissues of the shoulder represent metallic susceptibility artifact related to prior surgery. Suture anchors are again noted within the humeral head posteriorly.ROTATOR CUFF: The infraspinatus tendon appears thickened. Its posteroinferior fibers extend toward the aforementioned suture anchors and I suspect are intact. The anterosuperior fibers of the tendon however, appear to terminate between the humeral head and acromion process resulting in a cuff defect along the posterior margin of the supraspinatus. Increased signal intensity within the posterior fibers of the supraspinatus tendon likely represent a continuation of this defect. The remainder of the supraspinatus tendon is intact. Overall, these findings are similar to those on the prior examination, and might reflect the expected surgical outcome rather than a postoperative tear. Atrophy of the infraspinatus muscle appears similar to that seen on the prior study. There is mild fatty infiltration of the supraspinatus muscle along the myotendinous junction that also appears similar to that seen on the prior study. The teres minor tendon and muscle appear intact. The subscapularis muscle and tendon appear intact.SUPRASPINATUS OUTLET: Moderate osteoarthritis affects the acromioclavicular joint appearing similar to that seen on the prior study.GLENOHUMERAL JOINT AND GLENOID LABRUM: Glenohumeral joint alignment is normal. There is no joint effusion. Fluid separates the superior labrum from the underlying glenoid, but I suspect that this represents a sublabral recess rather than a labral tear. Mild heterogeneity of signal of the anterior labrum likely reflects degeneration. The posterior labrum appears intact.BICEPS TENDON: The tendon of the long head of the biceps is not visualized which may reflect a chronic tear or prior tenodesis/tenotomy.
Rotator cuff defect involving the anterosuperior fibers of infraspinatus tendon as described above appears similar to the prior study and may reflect the expected surgical outcome rather than a postoperative tear. Acromioclavicular joint osteoarthritis and other findings as above.