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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31322
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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My husband had a MRI done on his left shoulder after an injury

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My husband had a MRI done on his left shoulder after an injury at work. The findings are as follows:

1. Full thickness tear of the supraspinatus tendon at its attachment to the greater tuberosity.

2. Partial thickness tear of the supraspinatus tendon at its attachment to the humeral head. Cosiderable fluid in the gienohumeral joint space.

At the consultation with orthopedic, who admitting to not reviewing the case prior to the consult, the doctor stated that he did not feel that # XXXXX was "full thickness" but only "partial thickness" after reviewing some x-rays that were taken in the doctors office. He also added the diagnosis of a Left Biceps Rupture Traumatic (Long Head) because my husband had developed a "Popeye" muscle in between the MRI and the ortho consult.

I was concerned because it seemed as if we sitting in middle of two different diagnosis and asked if we should get another opinion to which the orthopedic replied, " Post mortem 80 year olds have show rotator cuff tears". My husband is neither 80 nor dead.....being only 51 and in good health other than the injury. I then asked if another MRI should be done to further clarify the full/partial tear differing medical opinions to which the orthopedic replied, " That would be a waste of four thousand dollars".

I am at a loss as to whether another medical opinion is warranted given the differing medical opinions from two different doctors. My guts says that another opinion would be warranted based upon my own experiences with breast cancer ( I was told I had a cyst and only after requesting different radiologist reading six months later was a biopsy perfomed that resulted in cancer) and that of my sister ( OB/GYN disagreed with radiologist report because of my sister's age (34) and only after two years passed was a biopsy performed which resulted in cancer. She died....) I know that these are my experiences but I see my husband sitting in the same place, between two doctors and their opinions, and I feel that he is deserving of a third opinion.

What do you think? Also, what is the treatment for a full thickness tear vs. a partial thickness tear? I tried to ask but by that time I feel the doctor was upset with me because I was asking so many questions.

Thank you for your time and attention!

I fully agree with you. He needs an another opinion. In older people, degenerative tears are common with occur due to aging and are spontaneous. While in a 51 year old, the rotator cuff / shoulder tears are due to an injury. An MR arthrogram is suggested to confirm the diagnosis. A combination of ultrasound, MRI and MR arthrogram would completely clear the picture. Please read this authentic study of the sensitivity of these investigative / imaging modalities in diagnosis;

In a partial thickness tear, physical therapy is the treatment of choice. While in a full thickness tear; arthroscopic surgery (key hole surgery / minimal access surgery) would be necessary.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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Customer: replied 3 years ago.
Thank you! I will follow up on behalf of my husband so that he can get the care that he deserve for his health and well being. :)
You are very welcome.

Good luck.