Patient History
Left shoulder and biceps pain with abduction extending into the elbow.
Findings
ROTATOR CUFF: No tendinopathy or tears.
SUBACROMIAL/SUBDELTOID BURSA: No bursitis.
Normal coracoacromial ligament.
Type 2/curved acromion with mild downsloping.
MUSCLES (ROTATOR CUFF/DELTOID, TRAPEZIUS, PECTORALIS): Normal musculature for age. No atrophy or volumetric loss.
BICEPS TENDON: The long head of the biceps tendon is intact. Negative for tendinopathy or tenosynovitis.
AC JOINT: Moderate AC joint osteoarthrosis with penetrating chondromalacia. No separation or ligamentous injury.
CORACOCLAVICULAR LIGAMENTS: Normal conoid and trapezoid ligaments.
SUBACROMIAL ARCH/OUTLET: Normal. Negative for stenosis or indirect signs of impingement.
SUBCORACOID ARCH: Normal. Negative for stenosis or displacement of the biceps pulley-anchor complex.
GLENOHUMERAL JOINT: Thickening of the inferior glenohumeral ligament and middle glenohumeral ligament (IGHL and MGHL, respectively).
Fibroinflammatory changes at the anterior rotator interval and axillary pouch.
Scant joint fluid.
Tiny penetrating chondral fissures with formation of subchondral arthropathic cysts at the anterosuperior glenoid cup.
No osteoarthrosis.
GLENOID LABRUM: Normal with intact anterior and posterior labrum. No SLAP lesions. No paralabral cysts.
BONES: Synovial pitting at the posterior humeral head facet commonly seen in the setting of internal impingement on abducting external rotation positioning.
SUBCUTANEOUS SOFT TISSUES: Mild periarticular soft tissue swelling more conspicuous at the axillary pouch.
AXILLA: No lymphadenopathy.
Impressions
1. Left shoulder glenohumeral joint capsulitis with diffuse infiltrative fibroinflammatory changes more conspicuous at the anterior rotator interval and axillary region with a thickened IGHL and MGHL.
2. Mild diffuse periarticular soft tissue swelling more conspicuous at the axillary pouch.
3. Tiny penetrating chondromalacia with subchondral arthropathic cysts at the anterosuperior glenoid cup.
