Date : 00.00.00
Name of the Patient : Abc Xyzvi Shlmn / F / 46 yrs.
Referred by : Dr. Abc Xyzesai.
Examination : M.R.I. of the Left Shoulder.
CLINICAL PROFILE :
C/O pain and limited movements of the left shoulder since 1 year.
M.R.I of the left shoulder was performed using the following parameters :
4 mm thick T1 Weighted and GRASS (with fat saturation) axial images.
4 mm thick T2 Weighted (with fat saturation) sagittal images.
4 mm thick T1 Weighted, Proton and T2 Weighted (with fat saturation) coronal images.
There is a tear of the inferior labrum. A synovial filled cavity is seen adjacent to the inferior labrum in connection with the tear of the labrum. This is hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted images and would represent a paralabral cyst.
Gross effusion is seen within the left shoulder joint. This is seen to extend along the supraspinatus tendon in the subacromial region. Extension is also noted along the bicipital tendon in the bicipital groove. Hyperintense areas are seen just below the subscapularis muscle lifting the subscapularis tendon which also represents synovial fluid. Fluid is also seen in the subdeltoid region extending in between the deltoid muscle and the infraspinatus muscles. There is synovial thickening. Debris (?? loose bodies are seen within the joint effusion).
A hyperintense signal is seen within the tendon of the supraspinatus muscle and this may represent a tear. Erosions are seen in the greater tubercle at the insertion of the supraspinatus tendon.
Subtle hyperintense signal is seen in the anterior portion of the glenoid on the Gradient images (scan 109.8). This is hypointense to normal marrow on the T1 Weighted images (scan 108.8) and would represent edema. Erosion of the cortical margin is also noted.
The acromio-clavicular joint is normal.
The visualized axilla is unremarkable.
In a known C/O rheumatoid arthritis, the MRI features are suggestive of :
1. Tear of the inferior labrum with a paralabral cyst.
2. Effusion in the left shoulder joint with extensions and synovial thickening as described.
4. Edema in the glenoid.
5. Tear of the supraspinatus tendon.