48-year-old female with shoulder pain and weakness. Evaluation of the shoulder is slightly limited due to inability to optimally position the patient.ROTATOR CUFF: There is increased signal intensity within the anterior fibers of the supraspinatus tendon suggestive of mild tendinosis. Additionally, there is a small focus of high signal intensity within the anterior fibers of the tendon at their insertion on the greater tuberosity. This involves the articular surface fibers and approximately 50% of the tendon thickness, but only measures 3 to 4 mm in both the longitudinal and AP dimensions. The supraspinatus muscle appears normal. There is thin linear increased signal intensity within the infraspinatus tendon, best seen on the sagittal oblique images, which may represent an interstitial tear, but we see no evidence of an surface tear. The infraspinatus muscle appears intact. There is thickening and mild increased signal intensity of the distal subscapularis tendon which may represent mild tendinosis, possibly exaggerated by redundancy of the tendon related to internal rotation of the humeral head. The subscapularis muscle appears intact. The teres minor muscle and tendon appear intact.SUPRASPINATUS OUTLET: Note is made of an os acromiale. Mild to moderate osteoarthritis affects the acromioclavicular joint. We see no frank fluid within the subacromial/subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: The glenohumeral joint alignment is within normal limits. There is a small amount of fluid within the joint, but no large joint effusion. Although we see no fluid signal intensity entering the labral substance, there is intermediate signal intensity within the superior labrum extending into the anterior labrum suggestive of a tear with small adjacent focus of fluid signal intensity indicating a paralabral cyst. The inferior glenoid labrum appears intact.BICEPS TENDON: The tendon of the long head of the biceps appears mildly thickened at its transition from the rotator cuff interval to the intertubercular groove suggesting tendinosis.ADDITIONAL
1. Mild rotator cuff tendinosis with a small insertional tear of the anterior fibers of the supraspinatus tendon as described above.2. Osteoarthritis of the acromioclavicular joint and os acromiale.3. Findings suggestive of a superior labral tear and small paralabral cyst.4. Other findings as described above.