Left shoulder pain. History of rotator cuff repair in July 2000. Recent fall. Evaluate for rotator cuff tear. Numerous foci of signal void within the soft tissues of the shoulder represent metallic susceptibility artifact from prior surgery.ROTATOR CUFF: The supraspinatus tendon is thickened indicating tendinosis. There is increased signal intensity within the anterior fibers of the distal supraspinatus tendon immediately proximal to its insertion on the greater tuberosity indicating a near full-thickness to full-thickness tear. The signal abnormality involves the majority of the thickness of the tendon, particularly the bursal surface fibers, although there may be a thin residual strand of tendon closer to the articular surface extending to the greater tuberosity. There is minimal (5 mm) retraction of tendon fibers. The tear is approximately 1 cm in AP dimension. There is mild to moderate fatty atrophy of the supraspinatus along the myotendinous junction anteriorly. The infraspinatus tendon appears slightly thickened, indicating mild tendinosis, but I see no discrete tear. There is mild fatty infiltration along the myotendinous junction of the infraspinatus. The teres minor muscle and tendon appear normal. There is mild thickening of the subscapularis tendon indicating tendinosis, with more focal increased signal intensity along its undersurface fibers that may reflect mild undersurface fraying/tearing. The subscapularis muscle is within normal limits.SUPRASPINATUS OUTLET: There is widening of the acromioclavicular joint presumably reflecting prior surgery. There is a small amount of fluid within the subacromial/subdeltoid bursa, particularly anteriorly. The coracoacromial and coracohumeral ligaments appear intact.GLENOHUMERAL JOINT AND GLENOID LABRUM: Glenohumeral joint alignment is within normal limits. There is mild surface irregularity of the anterior labrum which may reflect degenerative fraying. The labrum otherwise is unremarkable given the limitations of a non-arthrogram study. Trace amount of fluid within the glenohumeral joint is within normal limits.BICEPS TENDON: There is mild increased signal intensity within the tendon of the long head of the biceps at its transition from the rotator interval to the intertubercular groove, suggesting tendinosis.
Near full-thickness to full-thickness tear of the anterior fibers of the distal supraspinatus tendon and other findings as described above.