MRI results on my shoulder after falling out of bed

[rybread]

Here are the results from an MRI I had done yesterday on my shoulder:

findings:
rotator cuff tendons: no rotator cuff tear. Mildtendinosis of the lateral supraspinatus tendon. Moderate tendinosis and thickening of the laterl

subscapular tendon.


rotator cuff muscles: chronic grade 3/4 atrophy the teres major muscle. no evidence of a soft tissue mass in the quadrilateral space. No myositis.

acromion: type II

subacromial bursa: negative

a/c joint: negative



glenohumeral joint:
tear or the posteroinferior and labrum, without periosteal stripping plus tiny adjacent impaction type fracture of the posteroinferio margin of the glenoid

surrounded by a mild amount of bone edema, suggestive of a subacuete fracture.

the humeral head is internally rotated and moderately posteriorly subluxed on MRI exam and on the radiographic exam, likely due to anterior joint capsule

and subscapular tendon laxity.

My shoulder still hurts like hell and my doctor the ordered the MRI is out of town until Thursday. What does all of this mean and what can they do about it. I still can't lift my arm in front of me at my shoulder and they never checked to see why my tenodesis was so bad. I'm really freaked out about all of this. I can't lift my arm up high enough to get to the wheel on my chair or that the fork up to my mouth to eat. Somebody please tell me what all this means. It's really destroying my life right now.

[med100]

Ry, it should hurt according to the findings.. but you may wait for a doc to read this.
Did they treat the pain? Immobilize your shoulder? Offer any type of PT options?
Were NSAIDS or other anti-inflammatory meds or cold packs suggested to reduce inflammation? Maybe a nurse or someone else has more suggestions for you?

[TAM63]

Rye, I am so sorry. I can't really help with the MRI report - I'd just be guessing. Just wanted to say I'm sorry you're so upset and frustrated.

The only thing I know is that some labral tears heal on their own, and some require surgery.

Sounds like you need an opinion from an orthopedic surgeon - if the ordering doc wasn't one.

[arndog]

Ry - sorry you are going through this.
Like others have said, you need an ortho doc, hopefully a 'shoulder' specialist to see you. It sounds like you have a labrial tear and it has pulled a bit of the bone with it. I think the glenoid labrium is at the edge of the rotator cuff. It hurts like hell to tear it. ( I once tore my glenoid labrium). Sometimes it can heal on its own and other times it requires surgery. Fortunately the radiologist uses the word 'tiny'. Let's hope that means that your injury can heal up on its own. I look forward to hearing what the ortho doc has to say.
When I tore my labrium, it did heal on its own over many months.

[SCI-Nurse]

OK - I will try to answer some of your questions but you need your physician to put it altogether for you.

findings:
rotator cuff tendons: no rotator cuff tear. Mildtendinosis of the lateral supraspinatus tendon. Moderate tendinosis and thickening of the laterl subscapular tendon.

rotator cuff muscles: chronic grade 3/4 atrophy the teres major muscle. no evidence of a soft tissue mass in the quadrilateral space. No myositis.

acromion: type II

subacromial bursa: negative

a/c joint: negative

glenohumeral joint:
tear or the posteroinferior and labrum, without periosteal stripping plus tiny adjacent impaction type fracture of the posteroinferio margin of the glenoid surrounded by a mild amount of bone edema, suggestive of a subacuete fracture.

the humeral head is internally rotated and moderately posteriorly subluxed on MRI exam and on the radiographic exam, likely due to anterior joint capsule and subscapular tendon laxity.


You do not have a rotator cuff tear. Tendonitis is present and believe it or not, that can hurt an awful lot, especially since you really can not rest your shoulder. Your rotator cuff muscles have atrophied, probably due to your level of sci. You have quite a bit of laxity (stretched out muscle) in the glenohumeral joint (where the humerus (bone in the upper arm) meets the scalula). That can cause quite a bit of pain also. It also appears as though you have a small fracture that is not acute in the same area.

I don't know what you have tried to handle the pain. Ice or moist heat (depending on which feels better) can help to manage it, as can non-steroidal anti-inflammatories, such as motrin or even more heavy duty ones are not uncommon for this type of pain. You may need to immobilize it - but I am not sure how that would impact your adl's. How long is your doc not going to be around? Is there someone else in his practice that could give you a hand with this?

CKF

[Wise Young]

Originally Posted by rybread

Here are the results from an MRI I had done yesterday on my shoulder:


My shoulder still hurts like hell and my doctor the ordered the MRI is out of town until Thursday. What does all of this mean and what can they do about it. I still can't lift my arm in front of me at my shoulder and they never checked to see why my tenodesis was so bad. I'm really freaked out about all of this. I can't lift my arm up high enough to get to the wheel on my chair or that the fork up to my mouth to eat. Somebody please tell me what all this means. It's really destroying my life right now.

Ryan,

I am not an expert on the shoulder joint but, based on my understanding of the shoulder joint, you have had significant damage to your shoulder socket.

Let me start by describing the shoulder joint. Your shoulder is composed of three bones: the scapula (the wing-like bone that is in your back), the clavicle (the bone across the front top of your chest), and the humerus (the arm bone). The scapula forms a shallow socket in which the humerus head sits. The front of the socket is formed by ligamentous structures called a labrum and glenohumeral ligaments. Four muscles attach to the humerus. These muscles form the rotator cuff.


When you dislocate a shoulder, the humerus head pushes out of the socket through the labrum and glenohumeral ligaments, sometimes tearing them. If these ligaments don't heal properly, your shoulder will be more easily dislocatable in the future. If the tear is above middle of the glenoid socket, it is called a SLAP (superior labrum anterior to posterior) and may involve the biceps tendon. If the tear is below the middle of the socket, involving the inferior glenohumeral ligament, it is called a Bankart lesion (Source).

Usually when the MRI shows a SLAP, arthroscopic surgery is carried out to rule out and repair possible biceps tendon. Because a Bankart lesion is likely to cause instability of the shoulder, surgery is sometimes recommended to repair the tear (Source). The surgery, however, is significant and may not be achievable by arthroscopy.

According to your MRI report, you appear to have a Bankart lesion with possible fracture of the humeral head and stretching of other ligaments around the shoulder joint. Your rotator cuff appears to be oaky. In my opinion, you are likely to need surgery for three reasons:
1. A repaired tendon will heal faster than one that is not repaired.
2. You likely have an unstable shoulder joint.
3. It ensures stability of the shoulder for the future.

Please remember that I am not an expert on the shoulder joint but this discussion may help you ask your doctor questions when he explains the situation to you.

Wise.

[fishin'guy]

Try falling onto your head next time, like me, you'll be okay! Sorry your hurtin for certain.

[rybread]

Oh no, I can't fall on my head anymore, I already have seizures from the two times I have and they scare the hell out of my caregivers. LOL. I had a doctor call me and try to explain it to me but I didn't quite get it. My doctor is out of town until Thursday so I won't know until then. The doctor that called me wants me to put it in a sling or something but that is damn near impossible for me to do. I spend most of my days in bed so it's usually rested that way and when I have to go to a doctor's appointment or something, I need my arm to help hold my balance (not really grabbing things but just as a counterweight), I need it to use my mouse in bed and change the channel. I wish I didn't live alone but I don't really have a choice. It's been really difficult because I just can't lift my arm although I think it's getting a little better. The pain is pretty substantial and I guess I have to start taking some kind of anti-inflammatory. Is naproxen good for that? I already take it for my hip. I know Percocet hasn't helped the whole lot of course I kind of have a high tolerance to that since I've been taking it for so long.

[darkeyed_daisy]

See what happens when you threaten to kick my ass....LOL

Hope you feel better soon but looks like you will have to have that tear repaired. Take care of yourself.

[med100]

Hi Ry, Did they say cold pack or moist heat would help with the pain? Hope you start being more mobile again sooner and get some help with this.. .