51-year-old male patient with pain. Question of rotator cuff tear. ROTATOR CUFF:There is linear fluid signal intensity within the substance of the supraspinatus at its insertion on the greater tuberosity indicating a concealed tear. The tear measures approximately 1.5 cm in the AP dimension. We see no disruption of either surface of the tendon, although the tear does extend through the distal most fibers of the tendon to the surface of the greater tuberosity. Mild edema type signal more proximally along the myotendinous junction of the supraspinatus could represent a mild strain or edema due to impression by the overlying bones of the acromioclavicular joint. The infraspinatus tendon/muscle is intact. There is mild to moderate fatty atrophy of the teres minor muscle of uncertain etiology or clinical significance, but the deltoid muscle is normal. The subscapularis muscle/tendon is normal in appearance.SUPRASPINATUS OUTLET: Mild osteoarthritis affects the acromioclavicular joint with small osteophytes resulting in mild impression on the superior fibers of the supraspinatus. We see no frank fluid within the subacromial/subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: Glenohumeral alignment is within normal limits. We see no effusion. Intermediate signal intensity within the superior labrum particularly posteriorly is suggestive of degeneration or degenerative tearing. Rounded low signal intensity along the anterior and inferior aspect of the labrum is of uncertain etiology but may represent redundant capsular structures as the patient's arm is held in internal rotation. Alternatively, this could represent degenerative tearing of the labrum if the patient complains of instability. Further evaluation with MR arthrography can obtained if clinically warranted. Small cysts are noted in the posterolateral humeral head.BICEPS TENDON: Given limitations of a nonarthrogram study, the tendon of the long head of the biceps appears normal.
1. Concealed tear of the insertional fibers of the supraspinatus with mild edema along the myotendinous junction which may represent a strain or edema due to impression of the overlying structures of the acromioclavicular joint.2. Mild to moderate atrophy of the teres minor muscle of uncertain etiology or significance. 3. Acromioclavicular joint osteoarthritis.4. Labral degeneration/degenerative tearing as described above. If further imaging is clinically warranted, MR arthrography can be obtained.