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Dr. Abid
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Experience:  MBBS, FCPS(R)
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I have pain-it starts ( or ends) under my right shoulder blade,

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I have pain-it starts ( or ends) under my right shoulder blade, can go into my right upper quadrant of my belly, and goes down my flank, into right hip, pelvis and groin. This is the pain pattern- sometimes it is just in my right shoulder and flank, other times it travels the above pattern.
I have been to the ER and specialists numerous times. At first they thought it was a kidney stone because I have passed one before and because my urine always has leuks and blood. So I was sent to an urologist, Had CT...where they never saw any stones but where they did see a FNH on my liver and a LEFT sided hydronephrosis. Had a MRI...saw the left sided hydro. No issues on right side. Again confirmed FNH of liver. Went for cystoscopy, Retrograde pylogram, and Renal scan. No cancer. Kink in left ureter with no obstruction. No change in kidney function on renal scan. No problem on right side where my pain is. Urologist told me that this could not be causing my pain. In the meantime my menses was getting quite out of control and painful. So had transvaginal ultrasound. Saw a bulky uterus with cysts in uterus and saw abnormality which looked like adenomyosis on the back of the uterine wall. Now going to see gynecologist and going for biopsy and MRI of uterus. For past two week my pain is worse than ever and is not being controlled by the narcotics I have been given. I am getting strange "spasms" in my right abdomen that feel like a sharp stitch when you run but they are more constant and make me double over. The shoulder pain is really bad. Hip and pelvic pain is moderate but when I menstruate the cramping is more like being 4-5 cm dilated during labor than normal cramps a women gets. This pain lasts for a week while I continue to spot. On Friday the shoulder pain and funny stitch like pain in my side and abdomen got really bad. I took myself to the ER again because I am a nurse and frankly I thought I really needed to check this out to make sure something bad was not happening. I looked bad enough that I had an ultrasound done 45 minutes after I arrived. So...no Aorta issue, no gallbladder issue. FNH still seen. No stones, no kidney issues. Then I had a chest x ray and cardiogram. No cardiac issues. No emboli, no lifethreatening issues. They x ray showed degenerative disc disease in my thoracic spine. ER Doc said he thought pain sounded more like deep organ pain than spine pain. ? He also stated that while adenomyosis should not cause shoulder pain..that endometriosis can if it has attached to the diaphragm...So here are my questions. 1) Why is pain getting worse? 2) Can adenomyosis give this type of clinical picture 3) Can a FNH tumor of liver cause pain even though liver enyzmes etc are normal. 4) Could this be nerve root compression in thoracic spine plus adenomyosis. 5) if this were you what would you do next re getting help. The pain is becoming difficult to deal with and is affecting my life and work. Toradol and Naproxyn do nothing for the pain. Oxycontin works for the pain when it is not too bad but does not cover the bad pain.
Submitted: 9 months ago.
Category: Medical
Expert:  Dr. Abid replied 9 months ago.
Hi there.
Welcome to Just Answer and thank you for the question.
I am Dr.Abid a Medical Internist and will help you out.
I have read in detail info that you provided.
I strongly agree with dr that your pain is because of pinched nerves in thoraccolumbar spine.
Gradually worsening pain is because of increase in the severity of pinched nerve.
This pain is nothing to do with adenomyosis.kidney or liver problem.
Although for bulky uterus get test but it is not the reason of such a severe pain.
I will suggest you that before going for any other test you should get mri thoraccolumbar spine for proper diagnosis.
Treatment depends on exact diagnosis get mri and proceed further.
Regards XXXXX XXXXX luck.
Please leave positive feedback for me.
Thanks.
Customer: replied 9 months ago.


no the ER doctor did NOT think it was a pinched nerve but rather he thought that it was possibly endometriosis on my diaphragm. To you it sounds more like nerve root compression?

Expert:  Dr. Abid replied 9 months ago.
Thanks for follow up question.
Yes it is highly likely the nerve root compression and you should proceed with mri lumbosaccral spine.
This pain is not because of endometriosis.
Regards.
Positive feedback will be appreciated.
Thanks.
Dr. Abid, Doctor
Category: Medical
Satisfied Customers: 4216
Experience: MBBS, FCPS(R)
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