Ongoing shoulder pain ROTATOR CUFF: There is marked tendinopathy of the supraspinatus and infraspinatus tendons with a focus less than 1 cm of full-thickness tearing in the anterior most fibers of the supraspinatus. There is a small focus of high-grade partial undersurface tearing with retraction to the level of the acromioclavicular joint. A small focus of high signal intensity is identified along the superior fibers of the infraspinatus seen on series 9 image 7 representing interstitial tearing. There is mild fatty atrophy along the myotendinous junction of the infraspinatus muscle but otherwise the supraspinatus and infraspinatus muscles are preserved. The teres minor and subscapularis tendons and muscles are intact.SUPRASPINATUS OUTLET: Moderate osteoarthritis affects the acromioclavicular joint with degenerative cystic changes noted. There is a small amount of fluid identified within the subacromial subdeltoid bursa containing some areas of intermediate signal intensity.GLENOHUMERAL JOINT AND GLENOID LABRUM: Mild osteoarthritis affects the glenohumeral joint but alignment is normal and the labrum appears grossly intact. There is a small joint effusion containing foci of intermediate signal intensity reflecting a component of synovitis.BICEPS TENDON: Evaluation of the biceps tendon is limited given the internally rotated position of the patient. The intra-articular portion of the biceps tendon demonstrates enlargement and increased signal intensity (series 9 image 8) reflecting tendinosis however the tendon itself appears throughout its course. A small amount of fluid surrounds the biceps tendon reflecting extension from the glenohumeral joint.ADDITIONAL
1. Tendinosis of the supraspinatus and infraspinatus tendon with a small focus of full-thickness tearing of the distal anterior fibers of the supraspinatus tendon. There is additional high-grade undersurface tearing of the supraspinatus tendon with interstitial tearing of the infraspinatus tendon.2. Moderate osteoarthritis of the acromioclavicular joint.3. Small glenohumeral joint effusion with mild synovitis.4. Biceps tendinosis.