64-year-old female with shoulder pain. Rule out rotator cuff tear. ROTATOR CUFF: There is marked thinning of the supraspinatus tendon at the 12 o'clock position, just proximal to its insertion. On the coronal oblique images, the tendon is thinned to 1 mm or less over a longitudinal distance of approximately 1 cm, reflecting tearing along both the articular and bursal surfaces. There appears to be delamination of the articular surface and bursal surface fibers with approximately 1 cm of retraction. The tear is approximately 1 cm in the AP dimension, although it appears to extend posteriorly to involve the anterior fibers of the infraspinatus tendon to a lesser degree. There is tendinosis of the anterior fibers of the supraspinatus tendon at its insertion. There is interstitial tearing along the myotendinous junction of the supraspinatus tendon more proximally. Additionally, there is interstitial tearing along the myotendinous junction of the infraspinatus proximally. There is mild fatty infiltration along the myotendinous junction of the supraspinatus and infraspinatus which otherwise appear normal. The teres minor and subscapularis muscles and tendons appear intact.SUPRASPINATUS OUTLET: Mild osteoarthritis affects the acromioclavicular joint. There is a small amount of fluid within the subacromial/subdeltoid bursa. There is an os acromiale.GLENOHUMERAL JOINT AND GLENOID LABRUM: Glenohumeral joint alignment is within normal limits. There is no joint effusion. There is mild increased signal intensity within the superior labrum which may represent degenerative tearing, within the limitations of this non arthrogram study. There are subchondral cysts within the humeral head.BICEPS TENDON: The tendon of the long head of the biceps appears normal.
1. Marked thinning of the distal supraspinatus tendon as a result of articular and bursal surface tearing with additional interstitial tearing of the supraspinatus and infraspinatus tendons as described above.2. Mild osteoarthritis of the acromioclavicular joint.3. Os acromiale.