56 year old female with a history of left shoulder pain. Evaluate for rotator cuff tear. Evaluation of the shoulder is limited due to the patient's body habitus and patient motion artifact.ROTATOR CUFF: There is metallic susceptibility artifact indicating suture anchors with tunnels extending into the anterior and superior aspect of the humeral head. There is marked thinning of the supraspinatus tendon, likely reflecting chronic attritional tearing. Furthermore, there appears to be delamination of the tendon with retraction of the undersurface fibers to the level of the top of the humeral head. However, some fibers of the supraspinatus can be traced from the myotendinous junction to their insertion on the greater tuberosity. There is also suggestion of a small focal full-thickness defect of the tendon just above the vertex of the humeral head. Additionally, there is intermediate signal intensity within the posterior fibers of the supraspinatus tendon at their insertion likely representing insertional tendinosis. Cuff material is seen along the greater tuberosity superficial to the surgical tunnels, with what appears to be superficial partial-thickness tearing of the bursal surface fibers. There is mild atrophy of the supraspinatus muscle. There is moderate degenerative tendinosis of the infraspinatus tendon with foci of high signal intensity at its insertion likely representing concealed insertional tears and perhaps mild interstitial tearing along the myotendinous junction. There is moderate atrophy of the infraspinatus muscle. The teres minor muscle and tendon appear intact. There is mild increased signal intensity within the distal subscapularis tendon suggesting tendinosis. We see no discrete tear and the muscle of the subscapularis appears intact.SUPRASPINATUS OUTLET: Mild osteoarthritis affects the acromioclavicular joint. Fluid within the acromioclavicular joint may reflect prior surgery. There is a small amount of fluid within the subacromial/subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: The humeral head is slightly high riding. Evaluation of the glenoid labrum is limited due to the aforementioned technical factors and lack of intra-articular contrast. Portions of the labrum appear blunted likely representing degenerative tearing.BICEPS TENDON: The tendon of the long head of the biceps is situated within the bicipital groove as seen on the axial images. On sagittal oblique sequences the tendon appears enlarged with associated increased signal intensity likely reflecting tendinosis.
1. Limited study as described above. Postoperative changes of prior rotator cuff repair. There is marked thinning of the supraspinatus tendon likely reflecting chronic attritional tearing and retraction of delaminated undersurface fibers. There is also suggestion of a small focal full-thickness defect at the vertex of the humeral head. Other rotator cuff abnormalities as described above.2. Osteoarthritis and other findings as described above.