77-year-old female. Right shoulder pain. ROTATOR CUFF: Thickening and increased signal intensity of the supraspinatus tendon indicating moderate tendinosis. The articular surface fibers are slightly indistinct, which may reflect undersurface fraying. Fluid signal intensity within the anterior aspect of the tendon at its insertion on the greater tuberosity indicates an interstitial tear that involves the majority of the thickness of the tendon and is under just 1 cm in AP dimension. We suspect that this is a concealed tear, but a small amount of fluid in the adjacent subdeltoid bursa raises the possibility of a small tear of the adjacent bursal surface fibers. The supraspinatus muscle appears normal. The tendinosis extends posteriorly to involve the anterior fibers of the infraspinatus, but we see no definite infraspinatus tendon tear. The infraspinatus muscle is intact. The muscle and tendon of the teres minor and subscapularis are intact.SUPRASPINATUS OUTLET: Moderate osteoarthritis affects the acromioclavicular joint with spurring of the anterior aspect of the acromion. There is a small amount of fluid in the subacromial/subdeltoid bursa. A lobulated collection of fluid signal intensity along the posterolateral aspect of the humeral head at the infraspinatus insertion may reflect a loculated fluid in the subdeltoid bursa or a small cyst.GLENOHUMERAL JOINT AND GLENOID LABRUM: Small glenohumeral joint effusion. Alignment of the glenohumeral joint is anatomic. There is increased signal intensity within the anterior labrum suggestive of degeneration; the labrum otherwise appears normal considering the patient's age. Small cysts in the greater tuberosity anteriorly likely reflect overlying rotator cuff pathology. Small cysts posteriorly in the humeral head may not be of any clinical significance.BICEPS TENDON: Increased signal intensity within the long head of the biceps tendon suggests mild tendinosis. Fluid within the biceps tendon sheath may simply reflect extension of fluid from the glenohumeral joint.ADDITIONAL
Moderate tendinosis of the supraspinatus and infraspinatus with partial thickness insertional tearing of the anterior fibers of the supraspinatus tendon and other findings, as described above.