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Author Topic: Can someone please explain my MRI report for me?  (Read 7073 times)
Jimmy L
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« on: June 03, 2008, 03:24:01 PM »

I've had a few shoulder surgeries the last couple of years. I still have some discomfort in my shoulder. I got an MRI taken last week and am not scheduled to see my doctor to go over the report until tommorow. I was wondering if any of you guys can explain to me what this MRI report says.

Here is a copy of my MRI report:

EXAMINATION: MR of the right shoulder

CLINICAL INFORMATION: This is a 28-year old male with right shoulder pain. History of long head biceps tendon tenodesis and pectoralis major tendon tenodesis and repair, acromio-clavicular joint surgery and labral injury and repair. Right anterior shoulder pain.

TECHNICAL FACTORS: Using the shoulder coil and a 1.5 Tesla GE Signa Horizon Imager a MR examination of the right shoulder was taken. Oblique, coronal, sagittal, and axial images were taken utilizing T1 and FSE proton density, fat suppression, and gradient recalled technique. The patient received Magnevist 20 ml intravenously and uneventfully. The study was extended to the insertion of the pectoralis major on the humerus as well as to the region of the biceps tenodesis. MRI of the chest wall was not obtained after Dr. Lee discussed the case with Dr. Dick's office. If there is concern for sternal or clavicular origin injury of the pectoralis major, dedicated chest wall MRI is recommended.

FINDINGS: The patient is status post long head biceps tenodesis adjacent to surgical repair of the pectoralis major tendon at its insertion on the anterior humeral shaft. This is associated with minimal increased signal surrounding the distal pectoralis major tendon insertion with minimal regional contrast enhancement without discrete full-thickness retear of the pectoralis major itself. Findings likely represent some mild inflammatory change.

There is mild to moderate fluid distention of the subacromial-sub deltoid bursa with moderate contrast enhancement compatible with bursitis.

The patient has had prior supraspinatus tendon fixation as evidenced by a screw scar in the humeral head. There is no full-thickness tear of the supraspinatus tendon at this time with mild interstitial fraying and bursal surface fraying.

There is extensive degeneration of the glenoid labrum which demonstrates multiple anterior and posterior scar for screw sites in the bony glenoid. This is associated with mild cartilage thinning and irregularity of the bony glenoid and and humeral head with questionable early osteophyte formation. The acromio-clavicular joint demonstrates some postsurgical changes. When compared to the prior right shoulder MRI of 11/23/2007 and 12/12/2007, no significant interval change of the pectoralis major or biceps tendon repair is identified.

IMPRESSION:

1. Status post biceps tenodesis which is adjacent to pectoralis major tendon repair at its insertion on the anterior humeral shaft. This is associated with minimal increased signal and enhancement in this region likely related to mild inflammatory change. There is no full-thickness retear of the pectoralis major or biceps tendon.

2. Mild to moderate subacromial-subdeltoid bursitis with associated regional postsurgical change at the acromio-clavicular joint.

3. Supraspinatus tendinopathy with fraying with adjacent fixation screw in the humeral head.

4. Mild diffuse degeneration of the glenoid labrum which is associated with mild cartilage thinning of the glenoid and humeral head and questionable early osteophyte formation. (Status post multiple screw scar fixation sites identified) Findings are compatible with mild osteoarthritic change.
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pumpster
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« Reply #1 on: June 04, 2008, 06:30:07 PM »

Just wait and talk to the doc, someone with more information in front of them than anyone here would. Get a second opinion from another doc if you want, but to ask here is absurd no one here will understand the nuance the way a qualified person with your files in front of them would.
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Jimmy L
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« Reply #2 on: June 05, 2008, 08:11:05 AM »

 
I should have told you guys this but I left it out (like the idiot that I am). I had my last surgery on April 1, 2008. During that surgery I had my labrum repaired (1 anchor anterior and 4 anchors posterior), I had an interstitial RC tear repaired, scar tissue removed, and my bursa removed.

I met with my doctor yesterday. I spent nearly an hour in his office. He fully went over the MRI report with me and he even looked at the MRI himself. He said this:

*That I have some mild degeneration of the labrum but that it is normal considering I've had 2 labrum surgeries before (last one being April 1, 2008). He said it's very mild and that it should no way prevent me from boxing and weightlifting in the future. He said that taking glucosamine, chrondroitin, and MSM should slow down the progression over the years and even help fight inflammation.

*I have mild bursitis but that is normal considering my last surgery was on April 1, 2008 and during that surgery he removed the bursa so it's just grown back.

*He said my RC looks like it's healing nicely since my April 1 surgery. He compared it to the pre surgery MRI.

*He said I have some inflammation and scar tissue in the long head biceps tendon near the tenodesis (that I had done in Nov 06). He gave me 2 cortisone shots, 1 in the biceps attachment near the tenodesis and 1 in the front delt. He said that would kill some of the inflammation and dissolve some of the scar tissue. He said if he gave me the shot and it didn't work, 6-12 months from now he would go back in and clean out any scar tissue near the biceps attachment and would maybe even detach the biceps tenodesis and re tack it down.

I must say my biceps and shoulder feel ALOT BETTER!!!! Here is the time line my doc went over with me:

*Had surgery April 1, 2008

*Started PT April 2, 2008

*Mon June 9, 2008 start the 10 shoulder PT exercises (prone rows, dumbbell abduction with external rotation, external cable rotation, full can scaption dumbbell raises, full can dumbbell front raises, serratus punches, internal cable rotation, shoulder phone book pressdowns, seated dumbell curls, and tricep pushdowns). Do for 6 weeks.

*Mon July 21, 2008 stop doing 10 shoulder PT exercises and start doing normal weightlifting routine but start VERY LIGHT and each week gradually move up in weight. Do for 6 weeks.

*Mon. Sept 1, 2008 keep weightlifting but now I can start my boxing training.

A few questions I have for you guys:

1. What do you guys think of my meeting with my doc? Did he do the right thing by giving me the cortisone shots? Do you like his time line for me?

2. My doc told me that the cortisone shot will not only kill some of the inflammation in the bicep but more importantly it will dissolve and break up some of the scar tissue that is causing me problems. My question to you is...how long does it take for the cortisone to affectively dissolve some of the scar tissue? I know a cortisone shot usually kicks in and kills some inflammation in about 48 hours but I doubt it will dissolve scar tissue in that short time frame. I'm wondering how long it takes to dissolve scar tissue? When should I see the effects of the scar tissue being dissolved? 4 days? 3 weeks? 1 month? When?

3. When I start doing exercises again (PT exercises and normal weightlifting exercises) will that help break up the scar tissue near my bicep? What about when my PT stretches out my shoulder next week? Will that help?
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PANDAEMONIUM
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I pick on noobs because they deserve it


« Reply #3 on: June 05, 2008, 10:02:39 AM »

Like pumpster said, just wait until you can see the doc tomorrow and find out a real expert opinion.

It's not like you're dying of brain cancer and have 3 weeks to live.  There's no urgency here...you can wait another day.
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eho
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Support Canadian Chiropractic


« Reply #4 on: June 07, 2008, 09:25:35 PM »

Pumpster's right, although I do appreciate the practice..

Graduation in 6 days.  woot. Cool
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