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Im grasping here because my Ortho is out of the country until Tuesday. However Sunday im leaving out of the country for a week. I just got my MRI back and its all chinese to me! Need to wait until the 24th to get the results unless I can find a fine individual on one of these forums that can help a fella decipher this.
Any help is appreciated. Im assuming at this point ive a Bursitis and need a Mac Decompression perhaps. Been on Ice and Heat and limited mobility for 3 weeks with zero improbement.
MRI results per Radiologist as follows (apologies in advance if this is the wrong forum or protocol):
Any help is appreciated. Im assuming at this point ive a Bursitis and need a Mac Decompression perhaps. Been on Ice and Heat and limited mobility for 3 weeks with zero improbement.
MRI results per Radiologist as follows (apologies in advance if this is the wrong forum or protocol):
PROCEDURE:
MR Right Shoulder (MRI EXT UPPER JOINT W/O CO)
HISTORY:
Possible rotator cuff tear. Sharp aching pain to the arm. Previous arthroscopy 1987.
TECHNIQUE:
Axial, sagittal, coronal T1 and T2-weighted sequences obtained.
FINDINGS:
Minor dorsal capsular thickening of the acromioclavicular joint with minor scarring of the joint capsule. Mild cartilage thinning. Laterally downsloping flat undersurface configuration of the acromion. Minor thickening of the coracoacromial ligament centrally at the acromial undersurface insertion, coronal 18. Sagittal 14 and 13. Minor sliver of fluid seen in the far anterior subdeltoid bursa.
Moderate thickening with patchy areas of tendons scarring insertion of the supraspinatus tendon more notable anteriorly however involves the rotator cuff from anterior to posterior. There is focal mild inflammation of the anterior joint capsule and slight inflammation of the articular insertion of the rotator cuff tendon without tear. Axial image number nine, sagittal image number 16, coronal image number 15 and 16. Mild focal capsulitis which may be associated with mild tendonitis and insertional tendon strain.
Matted soft tissue thickening and mild scarring margins rotator interval surrounding distribution of the coracohumeral ligament, superior glenohumeral ligament complex. Sagittal 12, 11 and 10. Differentiation of the ligament structures is difficult due to the matted fibrous areas of scarring surrounding the soft tissues.
Notable thickened band of scar tissue within the subscapularis tendon distally and moderate atrophy of the myotendinous junction. Overlapping thickened scarring of the tendon complex adjacent to the anterior inferior and anterior glenohumeral joint complex. This patient may have had a subscapularis tenodesis, capsuloraphy and a version of a Putti Platt procedure. Given this surgical history, no gross intermediate signal or fluid signal breakdown of the capsule around the anterior humeral or glenoid insertion. No breakdown of soft tissue appreciated. Low signal band of fibrous tissue remains closely approximated to the glenohumeral articulation. The notably thickened mass of soft tissue scarring may contribute to some degree of impingement or possibly decreased range of motion. Alternatively, if there is no history of some type of capsuloraphy procedure this amount of soft tissue, subscapularis and capsular scarring may be result of the previous surgery for labral repair. Given this, again there is moderate scarring of the subscapularis tendon with mild atrophy of the myotendinous junction however, the scar tissue closely approximated across the glenohumeral articulation and adherent and matted to the capsule and glenoid anteriorly.
The biceps tendon remains properly located within bicipital groove. There is moderate thickening and intermediate signal within the distal intra-articular portion of the tendon to the extreme cranial bicipital groove entrance. Mild intermediate signal soft tissues surrounds the distal intra-articular course of the tendon likely contributing to some degree of decreased excursion or frictional tendinopathy. This may be some mild synovial or tenosynovial inflammation.
Biceps labral anchor is intact. The humeral head in prone position during MRI lies relatively subluxed posteriorly with respect to the glenoid articular fossa. There may be some moderate laxity of the joint. Moderate area of near full-thickness chondral thinning of the posterior mid to inferior glenoid is noted and there is undermining mild bone reaction and slight cystic change in the posterior inferior glenoid which may represent area of repetitive stress from glenohumeral joint laxity. Coronal image 11, sagittal image seven, and axial image 14 and 15. Remainder of the glenoid cartilage centrally and cranially is fairly well maintained, mildly thinned. Inferiorly and anteriorly at the cartilage is moderately thinned and slight fraying minor irregularity. The posterior central humeral head cartilage is moderately thinned. No subchondral bone edema. No gross trabecular sclerosis. In the cranial mid and anterior humeral head cartilage is fairly well maintained.
The posterior chondral labral sulcus from superior to inferior is flattened and blunted. The normal concavity is blunted. This may also be sequela of degenerative repetitive posterior joint laxity and stress.
The superior labrum demonstrates some minor intermediate signal granulation and likely result of remote delaminar degenerative injury without fluid signal tear or detachment. The anterior labrum to the equator is slightly frayed and mildly blunted and anterior inferior labrum ligamentous complex is matted and scarred within the subscapularis, capsular complex as described above. Three susceptibility artifact tracts within the anterior to inferior glenoid is demonstrated related to the previous labral tear.
IMPRESSION:
In prone position during MRI scanning the humeral head sits relatively partially subluxed posteriorly with respect the glenoid and there is moderate focal chondromalacia across the posterior articular surface glenoid as described above. There is moderate blunting and flattening of the posterior glenoid chondral labral sulcus likely on a chronic basis related to posterior glenohumeral stress.
Correlate for previous surgical history of capsuloraphy, subscapularis tenodesis and Putti Platt procedure. There has been previous hardware, labral anchor repair. Scarred, thickened subscapularis tendon, capsule and glenohumeral labro ligamentous complex is matted to the anterior glenohumeral joint and closely approximated. No fluid signal or intermediate signal breakdown in this complex. There is minimal sliver of overmining anterior subcoracoid bursitis and there is a minor sliver of the far anterior subdeltoid bursitis.
Moderate chronic insertional supra and infraspinatus tendinopathy with minor far anterior tendonitis and slight adjacent capsulitis focally.
Remote and granulation healed superior labral tear versus mild degeneration without fluid signal tear or detachment.
Moderate intra-articular course biceps tendinopathy with slight tenosynovial thickening and inflammation surrounding this portion of the tendon.
