Left arm lymphedema and new left shoulder pain, known breast cancer There is severe osteoarthritis of the glenohumeral joint with diffuse cartilage loss and bone-on-bone apposition of the humeral head and glenoid. There is abnormal signal intensity within the glenoid which is favored to represent subchondral sclerosis and cyst formation rather than metastatic disease. There is flattening of the superomedial surface of the humeral head thought to reflect chronic remodeling with additional degenerative marrow edema and cystic changes in the underlying humeral head. There is a moderate-sized joint effusion with synovial enhancement indicating synovitis.There is intermediate signal intensity within the distal fibers of the supraspinatus suggesting tendinosis but we see no full-thickness fluid-filled tear. There is mild atrophy of the supraspinatus muscle. Mild insertional tendinosis also affects the infraspinatus tendon but again there is no evidence of a full-thickness tear. The teres minor and subscapularis tendons and muscles are normal.A trace amount of fluid is present within the subacromial-subdeltoid bursa. The acromioclavicular joint is normal. There is fluid within the biceps tendon sheath likely reflecting extension from the glenohumeral joint with mild associated tenosynovial enhancement. Evaluation of the intra-articular portion of the tendon of the long head of the biceps is limited given the internally rotated position of the patient but it otherwise appears grossly intact.
Severe glenohumeral joint osteoarthritis with other findings described above.