Severe degenerative changes in the left shoulder include loss of the glenohumeral joint space, subchondral sclerosis and irregularity, marginal osteophyte formation and glenoid deformity. In addition, the distance between the inferior aspect of the acromion and the humeral head is decreased, and sclerosis is also evident, suggesting rotator cuff tear arthropathy. The deformation of the humeral head and distal third of the clavicle is also seen.