58-year-old male with pain and weakness. Rule out rotator cuff pathology. ROTATOR CUFF: There is undersurface tearing of the supraspinatus tendon, of varying depth, but involving greater than 50% of the tendon thickness anteriorly. The bursal surface fibers appear to be spared, although there are small cysts along the anterolateral aspect of the greater tuberosity that may reflect a small full-thickness defect of the anterior-most fibers that is not appreciable on this study. Alternatively, the cysts may represent a small ganglion. There are small cysts within the underlying greater tuberosity as well. The aforementioned tear extends posteriorly to involve the infraspinatus tendon and measures approximately 3 cm in the AP dimension. We see no frank tendon retraction. There is increased signal intensity within the remainder of the supraspinatus indicating moderate tendinosis with an additional small interstitial tear along the myotendinous junction more proximally. There are also interstitial tears along the myotendinous junction of the infraspinatus. The supraspinatus and infraspinatus muscles appear intact. There is an intramuscular lipoma within the teres minor measuring just under 4 cm in length, 3 cm in the craniocaudal dimension and just over 1 cm in width. Otherwise the teres minor muscle and tendon appear intact. There is increased signal within the distal subscapularis tendon indicating tendinosis and probable undersurface fraying. The subscapularis muscle appears intact.SUPRASPINATUS OUTLET: Note is made of an os acromiale that is perhaps partially fused. Additionally, there is mild to moderate osteoarthritis affecting the acromioclavicular joint. There is no significant fluid within the subacromial/subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: The glenohumeral alignment is within normal limits. There is no evidence of a glenohumeral joint effusion. There is increased signal intensity within the labrum including the superior labrum and posterior inferior labrum suggesting degeneration/degenerative tearing.BICEPS TENDON: There may be mild tendinosis of the intra-articular portion of the long head of the biceps, but we see no frank tear. ADDITIONAL
1. Tearing of the supraspinatus and infraspinatus tendons predominantly involving the undersurface with additional interstitial rotator cuff tears and tendinosis as described above.2. Acromioclavicular joint osteoarthritis, labral degeneration and tearing as well as other findings as described above