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On the Cover: A 62-year-old woman presented with chronic pain of her right shoulder. Examination revealed a massive irreparable rotator cuff tear and an os meso-acromiale (open arrow) with MRI signs of a regular osteochondral joint space (black arrow). A single intra-articular arthroscopic view from a standard posterior portal revealed degenerative chondral changes of the glenoid and humeral head, fraying of the long head of the biceps, and a mobile os acromiale, which is being pushed downward at the moment of the shot. A long head of the biceps tenotomy was performed and the patient has been pain free for over 10 months. See the accompanying video at www.arthroscopyjournal.org for more on this case. Courtesy of Nuno Sampaio Gomes, M.D., António Palhares Delgado, M.D., and Alcindo Silva, M.D.