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I have a question regarding shoulder MRI interpretation. My…

I have a question regarding...
I have a question regarding shoulder MRI interpretation. My doctor was called away on an emergency and I don't know when he'll return but am anxious to know what I'm looking at. I have fairly severe pain in my left shoulder with limited range of motion after a fall 2 months ago directly onto shoulder. The MRI results read as follows (I'm leaving out anything that reads "normal"):Findings:Acromioclavicular joint: Degenerative subchondral cystic changes with mild capsular edema.Glenohumeral joint: Large joint effusion. No intra-articular body.Rotator cuff:Supraspinitus: intermediate intrasubstance signal consistent with tendinitis. Tendon intact.Infraspinitus: focal, less than 50% thickness articular sided tearSubscapularis: partial articular sided tear, less than 50% thicknessLabrum: intermediate signal in the superior labrum, posterior to the biceps labral complex. No fluid signal detached tear.Impression:1. Large glenohumeral effusion with low grade partial articular sided tears of the infraspinitus and subscapularis tendons.
2. Superior labral tear.Can you explain what this means and most probably treatment?Thanks,
Gina
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Answered in 2 minutes by:
2/12/2018
Dr.Sawhney
Dr.Sawhney, Orthopedic Surgeon
Category: Orthopedics
Satisfied Customers: 7,676
Experience: More than a decade of post qualification experience
Verified
Thanks for your question.
I am Dr. Sawhney an Orthopaedic surgeon and I would be happy to help you today.
I am reviewing your question and would respond shortly.
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Thanks for your patience.
I would go through the MRI changes one by one.
MRI shows degenerative changes in the acromio clavicular joint. This is the joint which the collar bone forms with the scapula bone and it lies just in front of the shoulder. These changes are not due to the fall you had. But they may be responsible for some part of pain you are having.
Rotator cuff is a cuff of muscles around our shoulder which is responsible for controlling and stabilizing our shoulder when it moves. It has muscles namely supraspinatus, infraspinatus and subscapularis.
Your MRI shoes tendonitis in the supraspinatus muscle while infraspinatus and subscapularis muscle which form the back and front of rotator cuff respectively have tears. These tears are facing the articular surface that is towards the joint. Both tears involve 50% of tendon thickness.
Labrum is the thick fibrocartilage tissue farming a cuff around the joint surface of glenoid that is the cup of the shoulder joint in which the ball of the humerus bone that is a arm bone moves.
Labrum provides death to the cup and helps in stabilizing the shoulder joint which is otherwise most mobile joint of our body.
This labrum is torn at its highest point around the glenoid and maybe the most likely reason responsible for your pain. Euro cup and socket joint off the shoulder that is the glenohumeral joint has effusion meaning there is fluid in this joint. This fluid is usually a response to the injury as the inflamed tissue weeps fluid into the joint.
If the pain is persistent and disabling you may require arthroscopic surgery of your shoulder.
Feel free to ask any follow question.
Do take a moment to honor my work and time by rating my answer hopefully 5 stars.
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Please read less than 50% for the infraspinatus and subscapularis tears.
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Customer reply replied 4 months ago
Thank you for your Thorough response. One question: when the MRI says "detached tear" in the labrum...is that a full thickness tear and regardless of comfort, would that not be something to be surgically fixed as opposed to PT or "time"?Thanks
It does mean full thickness tear.
As I have mentioned earlier you are likely to require surgical treatment. But this decision has to be made by your surgeon after synthesizing the information gained from clinical examination with the MRI picture. Your surgeon may also like to have an MR arthrogram to better define the labral tear before going in for surgery.
Dr.Sawhney
Dr.Sawhney, Orthopedic Surgeon
Category: Orthopedics
Satisfied Customers: 7,676
Experience: More than a decade of post qualification experience
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Customer reply replied 4 months ago
Thank you so much!!!!
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