Chronic right shoulder pain, evaluate for rotator cuff tear. ROTATOR CUFF: There is moderate to severe fatty atrophy of the supraspinatus muscle. The supraspinatus tendon can be followed distally to the level of the glenoid beyond which it is ill-defined likely reflecting a chronic, full-thickness retracted tear. Similarly, there is severe fatty atrophy of the infraspinatus muscle, with most if not all of the fibers of the tendon torn and retracted to the level of the glenohumeral joint, with delamination of some fibers that appear retracted even further proximally. The resultant gap contains intermediate signal which likely represents scar tissue. The teres minor muscle and tendon appear intact. The distal subscapular tendon appears thickened and replaced with intermediate signal intensity likely reflecting a combination of severe tendinosis and full-thickness insertional tearing. There is minimal if any atrophy of the subscapularis muscle.SUPRASPINATUS OUTLET: An os acromiale is present. Mild osteoarthritis affects the acromioclavicular joint. A trace amount of fluid is present within the subacromial/subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: Mild osteoarthritis affects the glenohumeral joint. The humeral head is high riding consistent with chronic rotator cuff tear. A small cyst in the lesser tuberosity is likely degenerative in etiology. Intermediate signal within the superior and anterior labrum likely reflects degenerative tearing.BICEPS TENDON: The tendon of the long head of the biceps is perched upon the lesser tuberosity (indicating a biceps pulley lesion) with abnormal morphology suggesting partial thickness tearing. Fluid within the biceps tendon sheath may represent biceps tenosynovitis.
1.Extensive chronic appearing tearing of the rotator cuff with retraction as described above.2.Biceps tendon abnormalities including partial thickness tearing as described above.3.Osteoarthritis and other findings as described above.