45-year-old woman with chronic left shoulder pain following an injury in January 2010. She has undergone numerous orthopedic surgeries at outside hospitals. Multiple foci of signal void within the shoulder represent metallic susceptibility artifact related to prior orthopedic surgery. Tubular foci of intermediate to low signal intensity in the humeral head presumably represent suture anchor tracks. ROTATOR CUFF: There is moderate severe fatty atrophy of the supraspinatus muscle with severe tendinosis of the distal tendon. We see no definite fluid signal intensity to confirm full thickness tear. There is moderate to severe fatty atrophy of the infraspinatus tendon with tendinosis. There is moderate fatty atrophy of the superior portion of the subscapularis muscle with mild thickening and increased signal of the tendon distally suggesting tendinosis but we see no discrete tear. Teres minor muscle and tendon are intact. SUPRASPINATUS OUTLET: Mild deformity of the acromion presumably postsurgical. There is mild hypertrophy of the capsular structures of the acromioclavicular joint. We see no frank fluid in the subacromial/subdeltoid bursa. GLENOHUMERAL JOINT AND GLENOID LABRUM: Mild osteoarthritis affects the glenohumeral joint. We see no joint effusion. The inferior joint capsule subjectively appears slightly thickened. Increased signal within the superior labrum suggests degeneration/degenerative tearing. BICEPS TENDON: Extra-articular portion of the tendon of the long head of the biceps appears intact. Intra-articular portion of the tendon is not well visualized.ADDITIONAL
1. Severe tendinosis of the supraspinatus and infraspinatus tendons with moderate to severe muscle atrophy. There is no flow signal suggestive of definite tear.2. Mild osteoarthritis and postsurgical changes of the AC joint and glenohumeral joint.THE PATIENT SHOULD NOT BE CHARGED FOR THIS REPEAT EXAM DUE TO INITIAL POOR QUALITY.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.