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Jonathan Fay, M.D.
Jonathan Fay, M.D., Doctor (MD)
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Experience:  Physician health consultant
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I have upper left arm pain that is dull and constant pain.

Resolved Question:

I have upper left arm pain that is dull and constant pain. 3 to 4 weeks ago I saw my family MD and a local orthopedic surgeon. After having an MRI the orthopedic could not make a defenitive diagnosis (possibly a minor brachial-plex tear). I took pregnozon for 1 week and this alleviated the pain, but did not completely stop the dull constant pain. The pain feels as if its coming from the bone under my bicep. Could this be bone cancer or nerve damage not revealed by an MRI.
Submitted: 10 years ago.
Category: Health
Expert:  Jonathan Fay, M.D. replied 10 years ago.
Was the MRI of the arm, and did it include the shoulder and neck? And was the drug prednisone that you took? Was there any tramua involved? Let me know, and we'll try and get you some answers.
Customer: replied 10 years ago.
Relist:
Upper left arm pain. The drug was prednisone. Not trauma related. I do a lot of physical activities and lifting.The MRI did not include the neck, but did catch the shoulder and chest cavity.
Expert:  Jonathan Fay, M.D. replied 10 years ago.
Thanks for the additional info. MRI is, generally, very good at highlighting abnormalities in the tissues, and so it would likely pick up a mass (so long as it was large enough). Nerve damage might be harder to find via MRI, unless it was an obvious tear or inflammation of a large enough nerve. The Brachial Plexus, since it is a collection of nerves and fairly large, might be able to be visualized via MRI if it is damaged. I think that in general, however, nerve damage would be hard to visualize via MRI.

Nerve damage, in general, can produce pain, but often other symptoms will accompany it as well (weakness, numbness, tingling, loss of sensation, paralysis). You mention none of these other symptoms, so I am less sure of brachial plexus injury as a valid diagnosis.

So I think that, at this point, you shouldn't be too concerned about bone cancer or a tumor in the arm since you don't feel a mass, and you don't have any dysfunction, and nothing was seen on MRI. Orthopedists are the physicians, as well, who specialize in tumors of the bone and soft-tissue, so your orthopedist should also have considered and ruled out this possibility.

I think that it is possible that you might have another nerve injury, or entrapment of a nerve, that is causing this pain, but your description doesn't give a clear clue as to what might be the precise cause.

I would, if I were you, seek a second opinion. If you wish, see another family MD or internist, and another orthopedist as well. With the MRI on hand, and a good exam, and the fact that the prednisone helped, they should hopefully be able to steer you in a better direction and find you a little relief.

I hope that I have been of some help. Let me know if you have any more questions. Take care
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