Pulley Lesion-Shoulder MRI

FINDINGS:
The alignment of the different structures of the shoulder joint are well preserved. There is no evidence of instability, there is no evidence of dislocation. The bone marrow signal of the different bony structures is normal. No abnormalities are identified to the bone marrow. There is no evidence of microtrabecular lesion, hemorrhage, bony bruise, cortical disruption or fracture. There is evidence of osteoarthritis identified to the glenohumeral joint, with evidence of altered signal intensity in the superior labrum in its posterior part consistent with a SLAP lesion. Also noted is fluid in the subcoracoid bursa in relation to the superior part of the subscapularis tendon insertion likely consistent with a rotator interval tear. Long head of biceps shows some evidence of altered morphology and medial subluxation. . At the glenoid surface, there is evidence of subchondral sclerosis. There is evidence of synovial fluid in the joint in relation to the labrum and glenoid surface, distending the subglenoid recess. Fluid is also noted in the subdeltoid and subacromional bursa. There is evidence of osteoarthritis identified to acromioclavicular joint with irregularity of the articular surface, capsular distension. Acromion process shows minimally curved undersurface. There is evidence of altered marrow signal intensity in relation to the greater tuberosity of humerus with increased marrow signal in relation to the insertion of the suprasinatus and infraspinatus muscles consistent with insertional enthesopathy. The tendons of rotator cuff including supraspinatus, infraspinatus, subscapularis and teres minor tendons are normal. The bone marrow signal of the rest of bony structures is normal. No abnormalities are identified to the insertions of the deltoid.

IMPRESSION:
1. The findings are consistent with osteoarthritis of the glenohumeral and acrominoclavicular joint.. At the level of the joint, there is fluid in relation to labrum and glenoid surface, distending the inferior recess, in subdeltoid and subacromional bursa

2. There are findings consistent with posterosuperior labral tear (SLAP lesion) and rotator interval tear with fluid in relation to the superior border of subscapularis & subcoracoid bursa. 3. There is some atrophy of the long head of biceps and medial subluxation (may be a result of the “pulley lesion”)
4. Insertional enthesopathy in the humeral head in relation to supraspinatus tendon

5. No evidence of tear or retraction of the supraspinatus tendon is identified.

6. No evidence of a microtrabecular lesion was identified.