Avascular necrosis of the humerus, evaluate rotator cuff prior to shoulder arthroplasty ROTATOR CUFF: There is mild increased signal intensity along the articular surface of the supraspinatus tendon suggesting tendinosis and fraying although we see no discrete tear. There is minimal fatty atrophy along the myotendinous junction but otherwise the supraspinatus muscle is normal. The infraspinatus, teres minor, and subscapularis tendons and muscles are intact.SUPRASPINATUS OUTLET: The acromioclavicular joint is unremarkable. There is a trace amount of fluid in the subacromial subdeltoid bursa which is of questionable clinical significance.GLENOHUMERAL JOINT AND GLENOID LABRUM: There is flattening and fragmentation of the superomedial aspect of the humeral head with underlying signal abnormality indicating advanced avascular necrosis. Severe osteoarthritis affects the glenohumeral joint with full-thickness cartilage loss and degenerative edema type signal within the glenoid. There is deformity of the posterior labrum likely the result of tearing. There is a joint effusion with intermediate signal intensity present in the axillary and subscapular recesses which likely represents a combination of synovitis and debris.BICEPS TENDON: There is fluid and tenosynovitis within the biceps tendon sheath likely the result of extension from the glenohumeral joint however the biceps tendon itself appears intact.
1. Advanced avascular necrosis of the humeral head and secondary osteoarthritis of the glenohumeral joint.2. Mild supraspinatus tendinosis and undersurface fraying but no discrete fluid-filled rotator cuff tear is seen.3. Other findings as described above.