Infraspinatus tendinosis

35F, 169cm, 80kg. Type 1 Diabetic on Novorapid and have a Mirena, no other medications.
Can I please have anyone in the know break down this report for me in terms of seriousness. I am in so much pain and my shoulder is "frozen". Any attempts to raise it or reach behind my back results in terrible pain. Orthopaedic Surgeon initially diagnosed me with frozen shoulder, prescribed a cortisone injection and physio. Neither have helped. He finally requested an MRI and l've been able to see this report. I don't see the Dr for a few more weeks, but I want to be able to go in fully armed to plead my case for other methods of treatment. He is lovely buy I feel like he brushes me off. So how serious are these tears and other issues please?
MRI SCAN Findings: Humeral Findings: Humeral head is enlocated and well aligned. No acute fracture or bone marrow oedema. No evidence of a Hill Sachs deformity or bony Bankart. Partial thickness articular surface tear of supraspinatus tendon measures 8 x 8mm. A second separate small insertional tear involving anterior fibres measures up to 3.5mm. Tendinosis of infraspinatus. Subscapularis tendon is intact and of normal signal. Biceps tendon is enlocated within the bicipital groove surrounded by small amount of fluid. Minor partial tear involving the long head of biceps tendon proximal attachment at the glenoid ridge. Labrum remains intact. Articular cartilage is preserved Moderate acromioclavicular joint hypertrophy noted narrowing the cuff outlet indenting and likely impinging supraspinatus at its musculotendinous junction. Bigliani type 2 acromion. Small amount of subacromial fluid in keeping with bursitis.
Conclusion: Partial thickness articular surface tear of supraspinatus as well as smaller insertional tear involving its anterior fibres Suspected partial tear involving the long head of bicep tendon attachment at the superior glenoid ridge. Moderate acromioclavicular joint hypertrophy narrowing the cuff outlet indenting and likely impinging supraspinatus at its musculotendinous junction. Small amount of fluid at the subacromial bursa suggestive of mild focal bursitis.

35F, 169cm, 80kg. Type 1 Diabetic on Novorapid and have a Mirena, no other medications.
Can I please have anyone in the know break down this report for me in terms of seriousness. I am in so much pain and my shoulder is "frozen". Any attempts to raise it or reach behind my back results in terrible pain. Orthopaedic Surgeon initially diagnosed me with frozen shoulder, prescribed a cortisone injection and physio. Neither have helped. He finally requested an MRI and I've been able to see this report. I don't see the Dr for a few more weeks, but I want to be able to go in fully armed to plead my case for other methods of treatment. He is lovely buy I feel like he brushes me off. So how serious are these tears and other issues please?
MRI SCAN Findings: Humeral head is enlocated and well aligned. No acute fracture or bone marrow oedema. No evidence of a Hill Sachs deformity or bony Bankart. Partial thickness articular surface tear of supraspinatus tendon measures 8 x 8mm. A second separate small insertional tear involving anterior fibres measures up to 3.5mm. Tendinosis of infraspinatus. Subscapularis tendon is intact and of normal signal. Biceps tendon is enlocated within the bicipital groove surrounded by small amount of fluid. Minor partial tear involving the long head of biceps tendon proximal attachment at the glenoid ridge. Labrum remains intact. Articular cartilage is preserved Moderate acromioclavicular joint hypertrophy noted narrowing the cuff outlet indenting and likely impinging supraspinatus at its musculotendinous junction. Bigliani type 2 acromion. Small amount of subacromial fluid in keeping with bursitis.
Conclusion: Partial thickness articular surface tear of supraspinatus as well as smaller insertional tear involving its anterior fibres Suspected partial tear involving the long head of bicep tendon attachment at the superior glenoid ridge. Moderate acromioclavicular joint hypertrophy narrowing the cuff outlet indenting and likely impinging supraspinatus at its musculotendinous junction. Small amount of fluid at the subacromial bursa suggestive of mild focal bursitis.

First let me start by saying i've lost 290 lbs and just had my 2nd skin removal surgery and my absolute dream now after suffering from gyno and massive amounts of loose skin is to build muscle and complete my transformation. I tore my right rotator cuff in a weight lifting accident on 12/19/23 and hoped the rest from the skin removal of arm recovery would allow it time to heal. It did not so got MRI and results are below:
TECHNIQUE: Routine multiplanar and multi sequence MR imaging of the right shoulder was performed before and after the administration of 9 mL of intravenous Gadavist
FINDINGS:
Rotator Cuff: The supraspinatus demonstrates a tear which is full-thickness or near full-thickness. There is a clearly defined bursal side break on coronal image 10. The undersurface is somewhat equivocal on images 11 and 12. At least full-thickness equivalent. Arthrogram could further assess the undersurface if needed. There appears to be a partial-thickness oblique pinhole like defect in the infraspinatus coronal image 14 of the inversion recovery series. No abnormal enhancement seen in this region..Tendinopathy is present within the subscapularis. No high-grade tear.The teres minor is normal.
Biceps tendon:Intact.
Labrum: Degenerative signal. No acute pathology evident.
Acromioclavicular joint: Mild osteoarthritis with hypertrophy more pronounced cephalad.
Glenohumeral joint: Generalized chondromalacia without significant degree of bony degenerative change of the glenohumeral joint.
Musculature: No significant atrophy/fatty replacement.
Marrow: No evidence of fracture.No marrow replacement process or evidence of space occupying lesions.
Axilla : No pathologically enlarged lymph nodes.
Capsule: No acute findings.
Other: There is postcontrast enhancement in the subacromial and subdeltoid bursa with fluid signal. Compatible with bursitis.
MPRESSION:
Supraspinatus tear which is full-thickness or full-thickness equivalent without retraction
Focal fissure like tear of the infraspinatus.
Subscapular tendinosis
Glenohumeral mild osteoarthritis and acromioclavicular degenerative arthrosis
Bursitis.
I am so anxious to get back to boxing, planking, push ups, kayaking and most importantly weight lifting but many movements cause pain and severe weakness and sleeping is somewhat a challenge but putting pillows under my shoulders help. Left is also somewhat painful but not as bad and has not had imaging yet. Waiting for referral to orthopedic but just wanted to know if this is something that could be fixed with shots and physical therapy or if I should go ahead with the surgery. It is a major setback for me mentally because I still have open wounds in armpits from skin removal after 64 days, way longer than expected and wanted to be back at it by now and the thought of this surgery and a daunting 8 month recovery is super disheartening. I have also read about peptides and willing to try and would life any info that anyone would be kind enough to share.
This has been very difficult for me emotionally and mentally due to working so hard and for so long to get to this point and now be delayed. I am 44 years old and don't feel like I have many years to waste as I missed out on my 20's and 30's being nearly 500 lbs and immobile. Any help would be greatly appreciate! Thank you

Anyone know what to expect in terms of treatment/recovery/etc?
IMPRESSION:
Tendinosis with partial interstitial delamination tear of the distal supraspinatus insertional footprint.
Tendinosis with interstitial partial tear of the infraspinatus tendon and insertional footprint.
Scarring and fraying of the superior and posterior labrum.
Thickening of the inferior capsule and glenohumeral ligaments which can be seen with prior sprain or prior capsulitis.
Small effusion.
Mild AC joint arthrosis. Type II lateral downsloping acromion. Narrowing of the subacromial space. Subacromial subdeltoid bursitis.
Fibrocystic changes of the greater tuberosity.

Hi!
I got MRI results on my shoulder and it looks terrible. My appt with the ortho isn't for another week, but this looks like I will be getting surgery, right? I've had other joint replacements, so I guess I'm just trying to mentally prepare myself. Here are the findings:
ROTATOR CUFF: Low-grade fluid-intense interstitial tearing at the mid to posterior supraspinatus tendon footprint which appears to involve less than 30% of the cross-tendon thickness. Background of supraspinatus tendon thickening with heterogenous intermediate signal throughout the anterior to mid tendon over 6 mm anteroposterior and 10 mm mediolateral potentially representing additional tearing with scar remodeling and/or tendinosis. The infraspinatus, subscapularis and teres minor tendons appear intact. The subscapularis and teres minor tendons are unremarkable. Moderate fatty atrophy of the teres minor muscle. The rotator cuff muscles are otherwise preserved. No mass in the quadrilateral space.
CORACOACROMIAL ARCH: Mild AC joint arthrosis and os acromiale. The acromion is non-hooked.
GLENOHUMERAL JOINT: Marginal osteophyte formation at the glenohumeral joint. Broad full-thickness chondrosis throughout a majority of the humeral head and central to posterior glenoid with subchondral sclerosis/edema and articular surface remodeling. Degeneration and chronic tearing throughout the glenoid labrum. Moderate to severe proximal long head biceps tendinosis without tear.
OSSEOUS/BONE MARROW: As above. No fracture or additional significant osseous abnormality.
GENERAL: Moderate subacromial-subdeltoid bursitis. Moderate to large glenohumeral joint effusion with synovitis.
IMPRESSION:

1. Severe glenohumeral osteoarthrosis with broad full-thickness cartilage loss, articular surface remodeling, reactive subchondral changes and degenerative labral tearing.
   
2. Low-grade fluid-intense interstitial tearing at the supraspinatus tendon. Background of supraspinatus tendon thickening with heterogenous intermediate signal alteration which may represent additional partial-thickness (potentially high-grade) tearing with scar remodeling and/or moderate to severe tendinosis. Consider further characterization with MR arthrogram, as clinically indicated.
   
3. Moderate fatty atrophy of the teres minor muscle compatible with chronic denervation. No mass in the quadrilateral space.
   
4. Moderate to severe proximal long head biceps tendinosis.
   
5. Mild AC joint arthrosis and os acromiale.
   
6. Moderate to large glenohumeral joint effusion with synovitis and moderate subacromial-subdeltoid bursitis.
   

END OF THIS REPORT

Clinical Indications: Shoulder impingement.
Comparison: None available.
FINDINGS: There is no acute fracture or dislocation. There is no focal marrow edema or aggressive osseous lesion.
The glenohumeral joint demonstrates normal alignment with preserved articular cartilage. There are mild degenerative changes of the acromioclavicular joint, including capsular thickening and small osteophytes. There is a type II acromion.
There is mild supraspinatus and infraspinatus tendinosis with small partial-thickness articular-sided tears at the footprint insertion. The subscapularis and teres minor tendons are intact.
There is mild intraarticular biceps tendinosis. The extraarticular portion is normally positioned in the bicipital groove. No focal labral tear is identified. There is mild thickening and signal hyperintensity of the inferior glenohumeral ligament. Edema is noted in the rotator interval.
There is no muscle atrophy or edema. There is no joint effusion or fluid in the subacromial/subdeltoid bursa.
There is no axillary lymphadenopathy. The neurovascular structures are unremarkable.
IMPRESSION: 1. Small low-grade partial-thickness articular-sided tears of the supraspinatus and infraspinatus tendons at the footprint insertion, on background of mild tendinosis.

1. Findings suggestive of adhesive capsulitis.
   
   1. Mild intraarticular biceps tendinosis.
   2. Mild acromioclavicular joint osteoarthritis.

IMPRESSION:

1. Full-thickness tear of the supraspinatus, measuring 1.5 cm AP dimension; tendinosis and low-grade interstitial tear of the infraspinatus; and tendinosis of subscapularis; mild diffuse rotator cuff muscle atrophy.
2. Moderate to severe acromioclavicular arthropathy.
3. Mild-to-moderate glenohumeral cartilage disease.

I have a new job, and won't be able to take time off for a while. My ortho appt is next week, and I'm anxious about what he's going to tell me.
So I guess my real question is: How thoroughly screwed is my shoulder? Has anyone been able to baby something like this with cortisone shots?

“SHOULDER TECHNIQUE: Multisequence multiplanar unenhanced MR images of the left shoulder.
COMBATSON: Left shoulder ultrasound January 25, 2024. Blateral shoulder radiographs October 31, HISTORY: Suspected acute left supraspinatus tear 3 weeks ago. To confirm suspicion of full-thickness retraction or muscle atrophy for surgical planning.
FINDINGS: nys olued elen une su acron, fil/subdetoid bursa with mildly thickened vall.
ACROMIOCLAVICULAR JOINT AC joint alignment is maintained. Acromion is mildly low-lying.
ROTATOR CUFF Tuera f atus mersedis erade partial with partial-thickness articular sided tear of the posterdon cm short axis by 1.0 cm long axis. Superficial to this there is also low-grade partial width partial- thickness bursal sided tearing measuring 1.1 cm short axis by 0.6 mm long axis. There is suspected pinhole perforation/communication between them suspicious for a partial thickness non-retracted focal full-thickness component. This tearing is seen da fuse tendinosis of the supraspinatus tendon. There is focal mild tendinosis in the anterior infraspinatus. The subscapularis and teres minor are intact with no tendinosis or tear. he rodero the moatirtue enorma in inta and signal.
BICEPS TENDON Long head biceps tendon is normally located and shows normal signal intensity. No Hill-Sachs or osseous Bankart lesion. Labrum is intact. Glenohumeral ligaments are intact.
MISCELLANEOUS Suprascapular and spinoglenoid notches are clear.
IMPRESSION High-grade rotator cuff tear involving the posterior supraspinatus on a background of moderate diffuse the respective rotator cuff muscles. The labrum appears intact. No glenohumeral or AC joint arthropathy. Mild subacromial/subdeltoid bursitis.

“SHOULDER TECHNIQUE: Multisequence multiplanar unenhanced MR images of the left shoulder.
COMBATSON: Left shoulder ultrasound January 25, 2024. Blateral shoulder radiographs October 31, HISTORY: Suspected acute left supraspinatus tear 3 weeks ago. To confirm suspicion of full-thickness retraction or muscle atrophy for surgical planning.
FINDINGS: nys olued elen une su acron, fil/subdetoid bursa with mildly thickened vall.
ACROMIOCLAVICULAR JOINT AC joint alignment is maintained. Acromion is mildly low-lying.
ROTATOR CUFF Tuera f atus mersedis erade partial with partial-thickness articular sided tear of the posterdon cm short axis by 1.0 cm long axis. Superficial to this there is also low-grade partial width partial- thickness bursal sided tearing measuring 1.1 cm short axis by 0.6 mm long axis. There is suspected pinhole perforation/communication between them suspicious for a partial thickness non-retracted focal full-thickness component. This tearing is seen da fuse tendinosis of the supraspinatus tendon. There is focal mild tendinosis in the anterior infraspinatus. The subscapularis and teres minor are intact with no tendinosis or tear. he rodero the moatirtue enorma in inta and signal.
BICEPS TENDON Long head biceps tendon is normally located and shows normal signal intensity. No Hill-Sachs or osseous Bankart lesion. Labrum is intact. Glenohumeral ligaments are intact.
MISCELLANEOUS Suprascapular and spinoglenoid notches are clear.
IMPRESSION High-grade rotator cuff tear involving the posterior supraspinatus on a background of moderate diffuse the respective rotator cuff muscles. The labrum appears intact. No glenohumeral or AC joint arthropathy. Mild subacromial/subdeltoid bursitis.

51F with shoulder pain off and on for 15 years. Shoulder pain goes between acute and chronic depending on if I aggravate it. I have difficulty sleeping with my shoulder and wake up multiple times during the night.
These are my MRI findings....... Is the pain of surgery worth it? TIA
Shoulder MRI Findings:
-SUPRASPINATUS TENDON: 3 x 2 cm full-thickness tear
-INFRASPINATUS TENDON: Mild tendinosis but no discrete tear
-SUBSCAPULAR TENDON: Mild to moderate tendinosis. Suspected tiny low-grade interstitial tear
slightly above the insertional footplate, measuring 0.4 cm
-LONG HEAD OF THE BICEPS TENDON: Mild tenosynovitis
-AC JOINT: Mild to moderate AC joint OA.
-SUBACROMIAL/ SUBDELTOID BURSITIS: Mild subacromial subdeltoid bursal fluid.
-LABRUM: Intact
-ARTICULAR CARTILAGE: Mild to moderate chondrosis. Small joint effusion, without loculation.

I am stumped. I went in for an MRI. My symptoms are: no pain at rest, but I cannot do the neer test at all. It is painful. I guess I don’t know if a labrum tear is the same as rotator cuff tear? My doctor rushed me and I don’t really remember what he said. What do you make of these results, and have you had similar and what have you done?
IMPRESSION: 1.Focal fluid signal at the posterior supraspinatus tendon insertion measuring 6 mm in anteroposterior dimension with subtle cortical irregularity at the adjacent greater tuberosity and mild osseous edema. Findings may represent moderate grade partial intrasubstance tearing of the supraspinatus tendon versus possibly a partial osseous avulsion injury.
2.Mild supraspinatus and infraspinatus tendinosis.
3.Small subacromial/subdeltoid bursal effusion or mild bursitis.

Pt is 62 y/o, with a complete tear on a previously repaired supraspinatus at the insertion while lifting at the gym 2.5 weeks ago. Pt did powerlifting and bodybuilding for a long time, and had a complete tear in the R supraspinatus with no symptoms noticed, so when it was repaired, it wasn’t the best repair.
He got an MRI a week ago (about 1.5 weeks after the tear) showing “infraspinatus tendinosis”, pain in his shoulder has improved since the event at the gym. He has done workouts in the gym since then with no real change in his symptoms, per his report.
Upon exam, he had some scapular winging on eccentric phase shoulder flexion AROM, with some increase in anterior GH pain at about 90 degrees, so started him on serratus activation via wall slides, progressed to high plank to pike transitions with good effect and less pain upon retesting.
AROM into abduction and flexion actually look really good otherwise.
Resisted isometrics for GH ER at 0 abduction are painful on involved side.
Posterior capsule mobs help reduce pain.
Also started on ER reactive isometrics, which have been painful. Even sidelying ER iso holds are painful. I’m thinking next session I will just try wall iso in standing if need be to get the infrapinatus functioning better, since he will need it.
I’m sure he still has some joint effusion from the tear 2.5 weeks ago, so I’m trying to limit interventions that increase pain.
I can try pendulums for a while. I can try internal rotation movements. I can try lower trap and mid trap activating movements
Any ideas for approaching rehab of a tendinosis to improve other rotator cuff muscle function, in early phases of rehab and pain modulation, and any other ideas in general?
Thanks everyone :) I really appreciate you all and the good you do for the world.

Hello I am a 21 y/o male who is 5'9 and 160lbs with a history of shoulder subluxation. I have had 2 shoulder surgeries so far. My shoulder has been bothering me quite a bit to the borderline the worst it has been. I just got another MRI and my results came back. The impressions say 1. "Subtle tendinosis of the supraspinatus tendon and intraspinatus tendons, with subcortical cysts at the insertion of the infraspinatus concerning for internal impingement." 2. "Prior labral postsurgical changes in the anterior, anterior inferior, and inferior labrum, with no definite tear given limitation of non-arthrogram. " 3. "Subtle osteoarthritis of the acromioclavicular joint." I wonder what will my next steps look like for my shoulder. If anyone has any idea what my orthopedic surgeon will say please let me know so l can prepare. Thank you.

Shoulder injury from a near-fall 7 months ago. Had about 2 weeks of moderate, burning pain that I treated at home with naproxen & ice/heat. However, the pain keeps coming back periodically, along with significant popping & crepitus. It is mild, but it's being persistant. I have full range of motion. Finally went to ortho & my MRI results are:

1. Focal full-thickness tear involving the mid fibers of the supraspinatus tendon measuring 4 mm in AP dimension
2. No significant tendon retraction
3. Mild supraspinatus & infraspinatus tendinosis
4. Subacromial/subdeltoid bursitis
5. Mild acromioclavicular joint osteoarthritis
6. Mild cystic change of the humeral head beneath the rotator cuff

I know a full-thickness usually means surgery, but this tear is so small that I am wondering if it is really worth it? PRP was also offered as an option, but that doesn't seem to have good studies to show long-term benefits.
I would really appreciate any advice! I am really struggling with a decision.