Impingement question rotator cuff tear

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Case History

Technical Factors

Case Findings

Massive rotator cuff tear with up to 5cm of retraction of the supraspinatus and slightly less of the infraspinatus tendon. Complete. Subscapularis also is completely torn with 2cm of retraction. The muscular attachment remains preventing more substantial retraction. Teres minor tendon is intact.
Long biceps tendon is medially dislocated moderately tendinopathic but not torn.
Limited atrophy throughout. Up to grade 2 but no high-grade atrophy. Bursitis and capsulitis.
Lateral outlet stenosis and lateral tilt to the acromion.
AC joint mild proliferation without medial outlet stenosis. Coracoid is unremarkable does not contribute to anterior impingement.
Small anterior-inferior labral tear (series 2 image 5). Likely degenerative. However an old dislocation may produce a very similar finding. Not unstable active or acute labral tear.

Case Conclusion

Massive rotator cuff tear with up to 5cm of retraction of the supraspinatus and slightly less of the infraspinatus tendon. Complete
Subscapularis also is completely torn with 2cm of retraction. The muscular attachment remains preventing more substantial retraction
Long biceps tendon is medially dislocated moderately tendinopathic but not torn
Limited atrophy throughout. Up to grade 2 but no high-grade atrophy
Bursitis and capsulitis
Lateral outlet stenosis and lateral tilt to the acromion

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