Pain. Evaluate rotator cuff. ROTATOR CUFF: There is a full-thickness tear of the anterior fibers of the supraspinatus tendon at its insertion on the greater tuberosity, with just under 1 cm of retraction of the bursal surface fibers. The tear predominantly involves the anterior portion of the tendon, measuring approximately 1 cm in AP dimension. Mild thickening and increased signal intensity of the remainder of the supraspinatus tendon indicates mild tendinosis. The supraspinatus muscle is within normal limits. There is mild interstitial tearing along the myotendinous junction of the infraspinatus, but I see no full-thickness infraspinatus tendon tear. There is mild fatty atrophy along the myotendinous junction of the infraspinatus. The teres minor tendon and muscle appear intact. There is thickening and increased signal intensity of the subscapularis tendon indicating tendinosis. Furthermore, the undersurface fibers of the superior half of the tendon do not clearly contact the lesser tuberosity, and there is medial subluxation of the tendon of long head of the biceps along the lesser tuberosity, indicating at least undersurface tearing of the subscapularis. The subscapularis muscle appears normal.SUPRASPINATUS OUTLET: Mild to moderate osteoarthritis affects the acromioclavicular joint, with mild impression upon the superior fibers of the supraspinatus. There is a small amount of fluid within the subacromial/subdeltoid bursa extending along the posterior fibers of the supraspinatus muscle.GLENOHUMERAL JOINT AND GLENOID LABRUM: Glenohumeral joint alignment is within normal limits. Apparent detachment of the anterior superior labrum from the underlying glenoid may represent a normal variant, as the remainder of the labrum appears normal given the limitations of a non-arthrogram study. There are small cysts in the greater tuberosity likely secondary to the overlying aforementioned rotator cuff pathology.BICEPS TENDON: As stated previously, there is medial subluxation of the tendon of the long head of the biceps on the lesser tuberosity. The tendon otherwise appears intact.
Rotator cuff tears, medial subluxation of the tendon of long head of the biceps, and acromioclavicular joint osteoarthritis as described above.