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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31636
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Please tell me in english what the below means? And, would this be caused by me falling h

Customer Question

please tell me in english what the below means? And, would this be caused by me falling hard directly on the side of my shoulder? I had ZERO issues with my shoulder before this fall.. I fell going UP the stairs while delivering mail (letter carrier), I fell on my right shoulder hard, (on concrete) mail flying everywhere, sat there for a few minutes, then carried on my route and finished it... 8 days later went to emergency because by that point, it hurt when I took a deep breath.
Submitted: 1 year ago.
Category: Health
Expert:  Vakul Aren replied 1 year ago.
Hello,I am Dr. Aren and I will help with your query.It appears that you have damaged your shoulder joint,there is thickening/swelling and inflammation of the front muscular covering/ring or cuff around the joint. There is injury to the back side of the joint covered by the scapula,thickening with fluid accummulation at the glenoid or back part of the shoulder capsule and cord like ligament.This would be under the beak like structure of the scapula or shoulder blade,there is also damage to the front of the joint capsule and clavicle-acromion(beak of the scapula).There is a tear of the subscapular muscle at the back of the joint beneath the shoulder blade.It would be best to consult a good orthopaedic surgeon and seek his opinion regarding immediate and further management of the injury to the shoulder joint.
Expert:  Dr. Arun Phophalia replied 1 year ago.
Hello,
I am Dr. Arun and will be helping you today.
I am sorry that your question was unanswered for long.
Following is the meaning of MRI report:
fluid signal along undersurface of subscapularis tendon; this means tendon inflammation.
- marked thickening/ heterogeneity at junction of biceps tendon and subscapularis; this may mean partial tear of the tendon with inflammation.
- poor delineation of anterior labrum/suspect diffuse thickening through middle glenohumeral ligament -all findings could be associated withbuford complex although labral injury could give similar appearance; the cartilage of the shoulder joint is damaged.
- supraspinatus and infraspinatus intact; these muscles are normal.
- degeneration around acromioclavicular joint; age related change in shoulder joint (between shoulder blade bone and collar bone)
- fairly sharp downsloping go the acromion ; this findings indicate that it predisposes for the impingement of the tendon.
-- expect some component of injury to subscapularis; the muscle has injured fibers Z(muscle strain) -
poor delineation of the anterior gleaned labrum - suspect at least a partialsubscapularis tendon tear; partial tear of tendon.
Majority of people with above problems will respond to physical therapy alone. The program should be aggressive, daily and assisted by the physical therapist. The regimen consists of active and active-assistive range-of-motion exercises combined with stretching. Pain may occur early but within six to eight weeks progress is usually made. Other treatment modalities such as heat and massage may help. Nonsteroidal anti-inflammatory analgesics may also be beneficial. Deep electrotherapy in the form of short wave diathermy, Interferential current, trans cutaneous electrical stimulation, iontophoresis, phonophoresis also are very helpul.
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
It is privilege assisting you.
Please let me know if you have further queries or unanswered questions.
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Thank you.
Wishing you all the very best in life.
Customer: replied 1 year ago.
Would you this have been caused by my fall on the shoulder? As I said, no issues before with my shoulder. It is a wcb claim. I understand some people have tears in their rotator cuff and don't even know it.. I have an appointment with an orthopedic surgeon next week. What are the chances of surgery and would it just be the subscalpularis tendon that would be operated on or are any of the other issues operable as well? I am an active 43 year old female. I had a cortisone shot, which did not offer any relief at all. Doctor originally said I'd be doing physio, but after the mri results came back, she said not until I see the orthopedic surgeon. (Didn't expect to get in so fast, as the mri info came back on the 9th and my surgeon appt is the 15th) The pain isn't going away, the injury occurred on June 3, and the pain now seems to be more intense. Could this mean I'm damaging the tendons more by everyday use?
Expert:  Dr. Arun Phophalia replied 1 year ago.
Hello,Everyday use would not damage it or aggravate it. Though any strenuous work out or weight lifting can damage it further. You may require arthroscopic surgery for repair of the subscapularis and also for removing the inflammatory tissue.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.
Expert:  Dr. Arun Phophalia replied 1 year ago.
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