Reason: History of Right Shoulder Restriction, when moving arm backward. Need to rule out rotator cuff tears. History: Muscle Strain The extra-articular portion of the tendon of the long head of the biceps appears intact, without evidence of tenosynovitis. However, at the transition from the bicipital groove to the rotator interval the tendon becomes thickened and heterogeneous suggesting tendinosis; of note, the patient complains of pain when the transducer is applied to this area. The intra-articular portion of the long head of the biceps tendon is poorly evaluated on ultrasound examination. There are hypoechoic foci along the deep fibers the subscapularis tendon suggesting undersurface tears and fraying, but no full-thickness tear is evident. There is thickening and heterogeneous echogenicity of the supraspinatus indicating mild to moderate tendinosis, particularly posteriorly; hypoechogenicity within the deep fibers of the tendon at its insertion suggest undersurface tearing/fraying, but we see no fluid in the subdeltoid bursa or other findings to indicate a full-thickness tear. The infraspinatus tendon is somewhat hypoechoic which may reflect mild tendinosis, but we see no focal tear. The acromioclavicular joint is unremarkable.
Tendinosis and partial-thickness undersurface rotator cuff fraying/tearing as above. Findings suggestive of tendinosis of the tendon of the long head of the biceps at its transition from the bicipital groove to the rotator interval. This could be further evaluated with MRI, if clinically warranted.