73-year-old male with rotator cuff impingement. Evaluation is limited due to inability to optimally position the patient. The patient was severely claustrophobic and was unable to lie with his palm up, limiting external rotation.ROTATOR CUFF: There is increased signal intensity and thickening of the supraspinatus tendon indicating moderate tendinosis. There is a small (<1cm) focus of fluid signal intensity separating the anterior-most fibers of the supraspinatus from its insertion on the greater tuberosity indicating a tear, although it is difficult to determine whether this is a partial or full-thickness tear on this examination; we suspect that there is at least involvement of the bursal surface fibers. There is mild fatty infiltration of the supraspinatus along the myotendinous junction. There is also increased signal intensity and thickening indicating moderate tendinosis of the infraspinatus tendon. There are small linear foci of fluid signal intensity along the myotendinous junction likely representing interstitial tearing. There is mild fatty infiltration along the myotendinous junction. There is cyst formation within the greater tuberosity, likely reflecting overlying rotator cuff abnormalities. The teres minor muscle and tendon appear intact. There is thickening of the subscapularis which may reflect tendinosis coupled with redundancy due to internal rotation of the humerus. There is increased signal intensity along the undersurface fibers of the tendon suggesting a small partial-thickness tear.SUPRASPINATUS OUTLET: There is a small amount of fluid within the subdeltoid bursa anteriorly. Moderate osteoarthritis affects the acromioclavicular joint with osteophytes and capsular hypertrophy resulting in mild impression on the superior fibers of the supraspinatus.GLENOHUMERAL JOINT AND GLENOID LABRUM: The glenohumeral joint alignment is within normal limits. There is a small glenohumeral joint effusion. Mild osteoarthritis affects the glenohumeral joint. There is mild deformity of the superior labrum which may reflect a chronic tear with blunting of the anterior labrum that likely represents age-related degeneration.BICEPS TENDON: Evaluation of the biceps tendon is limited due to patient positioning, but we see no discrete tear. Fluid within the tendon sheath of the long head of the biceps may represent extension of fluid from the glenohumeral joint.
1. Osteoarthritis of the acromioclavicular and glenohumeral joints.2. Rotator cuff tendinosis with focal insertional tearing of the anterior fibers of the supraspinatus and focal undersurface tearing of the subscapularis tendon as described above.3. Other findings as described above.