I think there are two options. 1) Ultrasound and 2) a pneumoarthrogram with room air. Ultrasound's major drawback is limited assessment of a labral tear. A pneumoarthrogram is capable of delineating rotator cuff pathology, long head biceps tendinopathy, and labral pathology. I elected to do a pneumoarthrogram.
The top image is a paracoronal reformatted CT. The lower image is a conventional radiograph. Both are post injection of 10 cc room air. Both images reveal air in the SA-SD bursa,
Dx: Full thickness rotator cuff tear
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