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Technique: multiplanar, multi-sequence imaging has been performed after the administration of intra-articular gadolinium.
Findings No degenerative change related to the a.c. joint, however an os acromiale is present. No subacromial and subdeltoid bursal fluid. There is no fluid in the pseudoarthrosis, but there is mild subluxation of the ACJ in the ABER position (abduction in external rotation). No typical Hill Sach lesions, but there is a old mildly impacted fragmented fracture at the greater tuberosity involving the footprint of the posterior infraspinatus, without major tendon retraction. No tendinosis. Low signal foci in the posterior infraspinatus. This is associated with a 11 mm subcortical cyst deep to the footprint. rest of the rotator cuff tendons are intact. No muscle atrophy or signal abnormality. Normal long biceps tendon. Glenoid shows normal shape with no anterior deficiency. A prominent MGHL, small anterosuperior labrum, and high origin of the anterior band IGHL are noted.
Comment No SLAP tear. ?calcific tendinosis of the posterior infraspinatus. Old fracture of the posterior greater tuberosity involving IST footprint with subcortical cystic change. Os acromiale without pseudoarthrosis (joint cavity). Other signs of impingement are minimal.