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Indication: Right shoulder pain. Previous surgery.
Technique: Multiplanar MR imaging of the right shoulder obtained without contrast, with multiple pulse sequences.
Impression
1. Interval rotator cuff repair. Ill-defined interstitial tearing of the supraspinatus tendon involving urinary [sic] measuring up to 2.3 x 2.3 cm more prominent near the bursal surface; no well-defined full thickness defect, although subtle perforations cannot be excluded.
2. Moderate subscapularis tendinosis, with suspected ill-defined tear near the inferior margin of the musculotendinous junction.
3. Large glenohumeral joint effusion with distention of the subscapularis recess. Large effusion throughout the subcoracoid bursa with fluid tracking superficial to the subscapularis muscle; this may be related to suspected ill-defined tear near the subscapularis musculotendinous junction. Small amount of fluid at the subacromial bursa.
4. Glenohumeral joint: Mild DJD.
5. Mild degenerative changes and widening at the AC joint. Evidence for acromioplasty.
Quoted verbatim from the signed report. "involving urinary" appears in the original dictation and is presumed a transcription error.
Findings at a Glance
Glenohumeral Effusion
Large
Subscapularis recess distended
Subcoracoid Bursa
Large effusion
Fluid tracking superficial to subscapularis
Supraspinatus Tear
2.3 × 2.3 cm
Interstitial; no full-thickness defect
Long Biceps Tendon
Intact
No tear
Findings (Full Text)
Osseous Outlet and Acromion: Mild degenerative changes and widening at the AC joint. Evidence for acromioplasty.
Rotator Cuff: Interval rotator cuff repair. Ill-defined interstitial tearing of the supraspinatus tendon involving urinary [sic] measuring up to 2.3 x 2.3 cm more prominent near the bursal surface; no well-defined full thickness defect, although subtle perforations cannot be excluded. Moderate subscapularis tendinosis, with suspected ill-defined tear near the inferior margin of the musculotendinous junction. No significant atrophy of the rotator cuff musculature.
Glenohumeral joint: Mild degeneration of the labrum. Chondral thinning/fissuring at the superior humeral head. Large glenohumeral joint effusion with distention of the subscapularis recess. Large effusion throughout the subcoracoid bursa with fluid tracking superficial to the subscapularis muscle; this may be related to suspected ill-defined tear near the subscapularis musculotendinous junction. Small amount of fluid at the subacromial bursa. The long biceps tendon is intact.
Osseous Structures: No fracture or significant bone bruise. Suture anchors at the greater tuberosity. Subcortical degenerative changes at the greater tuberosity. No suspicious marrow lesion.
Miscellaneous: No soft tissue mass.
Surgical Context
The MRI describes an interval rotator cuff repair, evidence of acromioplasty, and suture anchors at the greater tuberosity — i.e. shoulder surgery occurred between the 07/23/2025 comparison MRI and this 07/06/2026 study.
| Item | Detail |
|---|
| Procedure | Right shoulder arthroscopy |
| Surgeon | Damion J. Valletta, DO — Valletta Orthopaedics |
| Surgery date | Not documented Not stated in the provided records; the post-operative packet was saved 08/26/2025 |
| Radiographic evidence | Interval rotator cuff repair; acromioplasty; suture anchors at greater tuberosity |
Why the effusions matter
Large glenohumeral effusion + large subcoracoid bursal effusion
The radiologist attributes the fluid to the suspected subscapularis tear. That is a reasonable mechanical explanation. It is worth noting alongside the rest of this record that recurrent sterile joint and bursal effusions are a long-standing pattern here — including a spontaneous, culture-negative right elbow hemarthrosis (01/04/2026) with 68% neutrophils and no crystals, and a decade-plus history of self-reported recurrent joint/bursal swelling.
This report neither establishes nor excludes an inflammatory contribution. If the effusion is aspirated, cell count with differential, crystal analysis under polarized light, and culture would distinguish a mechanical post-surgical effusion from an inflammatory one.
Patient Details
Bishop, Tyler
DOB: 05/26/1987 | Sex: Male
Patient ID: 11013030
Reading Radiologist
Benjamin Eyer, MD
Electronically signed 07/08/2026 09:22:00
Study Details
Date of Service: 07/06/2026 11:45
Modality: MRI, without contrast
Comparison: MRI 07/23/2025
Source: SimonMed / Ambra Health