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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 32156
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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MRI OF R-SHOULDER DEMONSTRATES LOW GRADE,PARTIAL THICKNESS

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MRI OF R-SHOULDER DEMONSTRATES LOW GRADE,PARTIAL THICKNESS OF SUPRASPINAYUS TENDON ON MARKED TENDINOSIS. AT TEARING. THERE IS A PROMINENT SUBCORTICAL CYST THE ROTOR CUFF FOOTPRINT 9MM .. 2.DIFFUSE ABNORMAL MARROW SIGNAL IS PRESENT EXTENDING INTO THE EPIPHYSEAL REGIONS . DIFFERERENTIAL CONSIDERATIONS WOULD INCLUDE A BEGIN PROCESSES SUCH AS BLOOD DYSCRASIAS ANEMIAS OR RED MARROW RECONVERSION VERSUS MARROW INFILTRATIVE PROCESSES SUCH AS LYMPHOMA, MULTIPLE MYELOMA, LEUKEMIA.

Hello Mary,
I am Dr. Arun and will be helping you today.

What were your symptoms for which MRI was done?
Any significant past medical history or surgery?

Do you have weight loss, off and on fever, loss of appetite, joint or bone pain?

Customer: replied 3 years ago.

I COULDN,T SLEEP ON R. SHOULDER WERY PAINFUL . THE POST OFFICE [25 YEARS] HEAVY LIFTING- PUSHING AND PULLING APCS FULL OF MAIL DID ME IN. NO SURGERY ON THIS ARM- I HAVE PAIN ON THE TOP OF THE BONE AND DOWN MYUPPER ARM. I DID PT. FOR 6 WEEKS. CAN'T FIX TEARS.

Thanks Mary for the detail.

This is likely to be partial rotator cuff tear with tendonitis. Those people who do not respond to the initial physical therapy are considered for the following;

 

1) A subacromial corticosteroid injection

 

2) A glenohumeral intra articular injection

 

3) Surgery; arthroscopic or open surgery for the repair of the tear.

 

You may also meanwhile contiue following;

 

1) Analgesics

2) Warm compresses

3) Physical therapy under water

4) Acupuncture

5) Deep electrotherapy; diathermy, therapeutic ultrasound, electrical stimulation etc.

 

The abnormal marrow signal may be just an incidental finding and may not be significant as many times, MRI can over diagnose (called as false positive, which means positive findings in the absence of disease). Still your orthopedic doctor may get the following investigations fone, for the cautionary reasons to rule out any abnormality;

 

1) Bone scan

2) Complete blood counts

3) Peripheral blood smear

4) Bone marrow cytology and biopsy.

 

Please feel free for your follow up questions.

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

Thanks for using Just Answer.

 

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Customer: replied 3 years ago.

DR. I ALSO G ET THE FEREHEME IRON INJECTIONS EVERY 4 MONTHS. FOR THE LAST YR. IS THIS CONNECTED ??? THANK YOU.. NO ONE SEEMS TO KNOW WHY MY CBC GOES DOWN TO A SCARY LEVEL OF 8..

You are very welcome, Mary.

The iron deficiency anemia is connected to the signal intensity change demonstrated in the MRI and explains it. Thus you may not need to go further investigations. A colonoscopy is usually advised as there can be polyps in the intestines (benign growths) which can bleed intermittently and can cause anemia. Ferritin is a blood test which evaluates for the total iron available in the body. Serum ferritin is the most useful test for diagnosing iron-deficiency anemia. Low serum ferritin (less than 12 ng/mL) is highly specific for iron-deficiency anemia. Please read this resource;

http://www.emedicinehealth.com/anemia/page5_em.htm

The most common causes are;

 

1) iron deficiency (with or without blood loss),

2) chronic disease/inflammation

3) chronic kidney disease

4) deficiencies of folate or vitamin B-12,

5) diseases of the bone marrow

6) hypothyroidism, hypersplenism, and hemolytic anemia

 

 

 

So investigations entail;

1) Complete blood count (CBC)

2) Peripheral blood film

3) Vitamin B-12

4) Folate

5) Reticulocyte count

6) LDH

7) Thyroid-stimulating hormone

8) Serum creatinine and estimated glomerular filtration rate

9) Serum ferritin

10) Serum iron

11) Total iron-binding capacity

So these investigations need to be done (if not yet done) for the exact assessment and long term management.

 

It is privilege assisting you.

Customer: replied 3 years ago.

DR. ALREADY HAD COLONOSCPOY AN ENDOSCOPY IN APRIL - N EGATIVE NO ULCERS OR POLPS AM I GETTING LEUKEMA ? WHAT CAUSED THE CYST ?..

I would not be worry than. Just iron deficiency anemia can cause the MRI changes. The iron deficiency is likely due to inadequate absorption of the iron from intestine and decreased metabolism. I would not be worried about leukemia. Cyst is caused by friction (age related changes in joint / degenerative arthritis) and is not considered serious or significant finding.
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