Reason: eval for rotator cuff pathology History: pain, limited ROM despite NSAIDs and PT course ROTATOR CUFF: There is near complete rupture of the supraspinatus tendon with approximately 4.5 cm of retraction of the proximal tendon fragment. There is thickening and intermediate signal intensity within the proximal tendon fragment indicating moderate tendinosis. There is fatty atrophy of the supraspinatus muscle. There is increased signal abnormality within the muscle belly of the supraspinatus on fluid sensitive sequences which may reflect an acute component/strain injury. There is extension of this tear to involve the anterior fibers of the infraspinatus. The infraspinatus muscle demonstrates minimal fatty atrophy at the level of the myotendinous junction. The teres minor muscle and tendon appear intact. There is near complete rupture of the subscapularis with approximately 2 cm of retraction of the proximal tendon fragmentSUPRASPINATUS OUTLET: There is a small amount of fluid within the subacromial subdeltoid bursa. Mild osteoarthritis affects the acromioclavicular joint.GLENOHUMERAL JOINT AND GLENOID LABRUM: Note is made of a high right humeral head. Moderate osteoarthritic changes affect the glenohumeral joint. There is blunting and deformity of the anterior labrum which may reflect degeneration and degenerative tearing.BICEPS TENDON: There is thickening and intermediate signal intensity within the tendon of the long head of the biceps indicating tendinosis. There is linear fluid signal abnormality within the tendon just proximal to its transition into the rotator interval indicating a longitudinal split tear. The intra-articular portion of the tendon of the long head of the biceps is not visualized likely representing complete rupture with retraction. ADDITIONAL
1. Complete rupture of the supraspinatus, near complete rupture of the subscapularis, and tearing of the infraspinatus with retraction as well as rotator cuff tendinosis as described above.2. Rupture of the long head of biceps tendon with retraction.3. Osteoarthritis of the shoulder.4. Glenohumeral joint effusion with probable synovitis. Other findings as described above.