63-year-old male with pain. Evaluate rotator cuff. ROTATOR CUFF: There is thickening and intermediate signal intensity within the supraspinatus and infraspinatus tendons indicating moderate tendinosis. There is also high signal intensity within the supraspinatus tendon at its insertion on the greater tuberosity representing a concealed interstitial tear, measuring approximately 1 cm in AP dimension, which involves approximately 1/3 to 1/2 of the tendon. There is also increased signal intensity at the insertion of the infraspinatus tendon more posteriorly which may represent additional insertional tearing without evidence of retraction. There may also be mild bursal surface fraying of the supraspinatus tendon. There is mild fatty atrophy along the myotendinous junction of the infraspinatus muscle but the supraspinatus and infraspinatus otherwise are normal in appearance. The teres minor and subscapularis tendons and muscles appear normal.SUPRASPINATUS OUTLET: Mild to moderate osteoarthritis affects the acromioclavicular joint with osteophyte formation and capsular hypertrophy resulting in mild impression upon the superior fibers of the supraspinatus tendon. There is a trace amount of fluid within the subacromial/subdeltoid bursa. There is minimal increased signal intensity within the bursa on fluid sensitive sequences which may reflect mild inflammation.GLENOHUMERAL JOINT AND GLENOID LABRUM: Moderate osteoarthritis affects the glenohumeral joint with scattered foci of signal abnormality within the labrum likely representing degeneration/degenerative tearing. There is linear signal abnormality partially separating the anterior labrum from the glenoid along with slight flattening of the lateral aspect of the humeral head which raises the possibility of prior anterior dislocation. There is a small amount of fluid within the joint but no large effusion is evident.BICEPS TENDON: There is thickening and increased signal intensity within the long head of the biceps tendon at its transition from the rotator cuff interval to the intertubercular groove, indicating moderate tendinosis. The tendon of the long head of the biceps is also perched upon the superior aspect of the lesser tuberosity which may represent a pulley lesion. There is fluid within the biceps tendon sheath which may represent mild tenosynovitis. There is a subcentimeter ovoid focus of intermediate signal intensity within the biceps tendon sheath which may represent a cartilage fragment.
1. Supraspinatus and infraspinatus tendinosis with insertional (likely concealed) tearing without evidence of retraction as described above.2. Acromioclavicular and glenohumeral joint osteoarthritis.3. Moderate tendinosis and tenosynovitis of the long head of the biceps tendon and other findings as described above. 