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Old 04-29-2008, 11:35 AM   #1
James R. Duwve
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Translating an MRI into plain English

I received the following report of an MRI done on my right shoulder. The Orthopedic explained it to me but, I didn't exactly digest what he said. Any help translating this into non medical speak would be appreciated.

There is moderate acromioclavicular joint osteoarthrosis with partial thickness chondral loss across the joint, subcortical cystic change and osteitis. Joint capsule is thickened, mildly edematous. Undersurface of the acromion is curved. There is mild lateral downsloping which narrows the subacromial outlet. Spurring is noted from the inferior joint line; this has mass effect at the musculotendinous junction of the supraspinatus. There is mild subacromial-subdeltoid bursitis.

There is mild supraspinatus and infraspinatus tendinosois. Signal is noted at the musculotendinous junction of the subscapularis with partial thickness intersitital tearing of the subscapularis tendon.

Synovial thickening and debris is seen with the subscapularis recess and rotator interval. Margins of the rotator interval are thickened. The long biceps is intact, not subluxed.

There is no glenohumeral effusion. Glenohumeral articular cartilage is intact. There is a degenerative SLAP tear with widened sublabral foramen and an irregular frayed posterosuperior labrum. This is in association with spurring of the posterior glenoid rim. Labrum appears normal at the level of the equator and below.

Muscle is normal in signal and bulk circumferentially about the cuff.

IMPRESSION:

1. Acromioclavicular joint osteoathrosis with joint line spurring causing mass effect at the cuff and lateral downsloping narrowing of the cuff outlet. 2. Mild cuff tendinosis and bursitis. 3. Degenerative SLAP tear.


My orthopedic said if it became necessary I would need a biceps tenodesis. He described two types. They both involved re-attaching the bicep tendon but, each one was to a different location. The one he preferred would result in a protrusion on my bicep kind of like Popeye. The other wouldn't.

I opted for a shot of cortisone for now. I have been in PT for it since November. Six weeks ago I under went a Meniscus repair on m right Knee. I was taking Naproxen and after 2 weeks my shoulders felt better than they have in 10 years. I was able to throw a ball pain free, something I haven't been able to do for years.

Any advice or comments would be appreciated. As for now I am only able to do upper body WOD's due to the Meniscus repair.

On the positive side I was able to do a complete revolution on the bike today. Once I broke through I did a 100 or so each direction. Seems trivial but I was proud of myself.


Thanks,

Jim
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Old 04-29-2008, 12:20 PM   #2
Steven Low
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Re: Translating an MRI into plain English

Quote:
Originally Posted by James R. Duwve View Post
I received the following report of an MRI done on my right shoulder. The Orthopedic explained it to me but, I didn't exactly digest what he said. Any help translating this into non medical speak would be appreciated.

There is moderate acromioclavicular joint osteoarthrosis with partial thickness chondral loss across the joint, subcortical cystic change and osteitis. Joint capsule is thickened, mildly edematous. Undersurface of the acromion is curved. There is mild lateral downsloping which narrows the subacromial outlet. Spurring is noted from the inferior joint line; this has mass effect at the musculotendinous junction of the supraspinatus. There is mild subacromial-subdeltoid bursitis.

Basically, you're shoulder joint is degrading with loss of some of the cartilage indicative of osteoarthritis. You probably have a type III acromion where you have to be very careful with overhead pressing & avoid behind the neck presses and upright rows. There is also inflammation

There is mild supraspinatus and infraspinatus tendinosois. Signal is noted at the musculotendinous junction of the subscapularis with partial thickness intersitital tearing of the subscapularis tendon.

So you're supra and infraspinatus have tendonitis (rest/light work is good for recovery) and you have a partial tear in your subscap. I'd say definitely take some time off to let it heal.

Synovial thickening and debris is seen with the subscapularis recess and rotator interval. Margins of the rotator interval are thickened. The long biceps is intact, not subluxed.

Scar tissue buildup in the joint... more or less. Will limit mobility

There is no glenohumeral effusion. Glenohumeral articular cartilage is intact. There is a degenerative SLAP tear with widened sublabral foramen and an irregular frayed posterosuperior labrum. This is in association with spurring of the posterior glenoid rim. Labrum appears normal at the level of the equator and below.

Ouch, degenerative SLAP tear... if it worsens you might need surgery. Hopefully not but it depends on type of SLAP tear.

Muscle is normal in signal and bulk circumferentially about the cuff.

IMPRESSION:

1. Acromioclavicular joint osteoathrosis with joint line spurring causing mass effect at the cuff and lateral downsloping narrowing of the cuff outlet. 2. Mild cuff tendinosis and bursitis. 3. Degenerative SLAP tear.

Hmm, a little too basic IMO. There's lots of crap going down in your shoulder.. most of it not good

My orthopedic said if it became necessary I would need a biceps tenodesis. He described two types. They both involved re-attaching the bicep tendon but, each one was to a different location. The one he preferred would result in a protrusion on my bicep kind of like Popeye. The other wouldn't.

Maybe.. maybe not. Long head of biceps is intact, but that's subject to change if the shoulder keeps degenerating

I opted for a shot of cortisone for now. I have been in PT for it since November. Six weeks ago I under went a Meniscus repair on m right Knee. I was taking Naproxen and after 2 weeks my shoulders felt better than they have in 10 years. I was able to throw a ball pain free, something I haven't been able to do for years.

Any advice or comments would be appreciated. As for now I am only able to do upper body WOD's due to the Meniscus repair.

On the positive side I was able to do a complete revolution on the bike today. Once I broke through I did a 100 or so each direction. Seems trivial but I was proud of myself.

I'd stay away from too much exercise/workout if there is even a small chance of stuff healing. It sounds like your shoulder is pretty messed up to the point you may need the surgery... but I mean the less surgery the better if it's possible to get some semblance of healing in...

On the upside.. now's a good time to work flexibility. Also, doing a bit of unilateral strength work with the left arm helps maintain strength in right arm.


Thanks,

Jim
Yeah, that's a pretty rough diagnosis.
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Last edited by Steven Low : 04-29-2008 at 12:23 PM.
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Old 04-29-2008, 01:16 PM   #3
James R. Duwve
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Re: Translating an MRI into plain English

Steven,
Thanks for the interpretation. I think I felt better when I didn't quite understand it.

I haven't been able to do any over head stuff for the last 6 weeks because of the knee. However, I have been subbing quite a bit of pullups (mainly dead hangs, I can't kip with my knee in a brace) and ring dips. And I just ventured back into HSPU and practicing holding a handstand for a minute.

Additionally, I have been performing a lot of rotator cuff strengthening exercises and working on opening up my shoulders and fixing my posture.

What would you suggest I leave out or add to my workout?

Thanks,

Jim
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Old 04-29-2008, 03:17 PM   #4
Garrett Smith
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Re: Translating an MRI into plain English

No nightshades. It will help stop the degeneration that is going on all throughout your shoulder.
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Old 04-29-2008, 04:56 PM   #5
Steven Low
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Re: Translating an MRI into plain English

Like Garrett said... diet is VASTLY important. If you're not staying away from sugars stay away. Try nightshades too to see if that helps. Fish oil and possibly some cartilage stuff like glucosamine/chondroitin might help.

I mean I would say keep doing stuff if it doesn't hurt but that MRI does sound pretty bad. If you can do unilateral work (left arm only) then do that. Try to stay away from heavy work or awkward positions on the shoulder. Definitely don't do anything that hurts.

Take my sig into consideration though. -_-
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Old 04-29-2008, 07:32 PM   #6
James R. Duwve
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Re: Translating an MRI into plain English

Garrett,

Today is the first I have ever heard of nightshades. However, I love them. I don't due potatoes but, I love peppers and tomatoes. I was telling my wife about them because she complains of chronic neck problems. I guess maybe we should both kick the habit.

Any thoughts on prolotherapy? Not sure I am ready to go under the knife again so soon. However, I also have left shoulder problems and am anticipating an MRi on it in the near future.

Also, Steven you mention supplements. What is the word on Hyaluronic Acid. I've noticed that it is be included with a lot of the glucosamine supplements.

Thanks,

Jim
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Old 04-29-2008, 08:55 PM   #7
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Re: Translating an MRI into plain English

Hyaluronic acid is a component of chondrocytes.. more or less connective tissue. So yes, generally paired with glucosamine.

Shark cartilage happens to contain a lot if you've ever heard of that.
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Old 04-30-2008, 07:17 AM   #8
Andy Shirley
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Re: Translating an MRI into plain English

What are your symptoms?

As far as the A/C osteoarthritis, there is a (relatively) simple surgery for this. I've had it done with good relief of the pain. Distal claviculectomy(mumford). Maybe an acromioplasty.

This changes little as far as function goes, but can siginificantly decrease the pain in your shoulder.

SLAP= Superior Labrum, Anteror to Posterior.
I've also had a my labrum repaired, with good results.

Also what Steven and Garrett said.

This is not medical advice, I'm just a guy on the internet who had good results from the above procedure.

Last edited by Andy Shirley : 04-30-2008 at 07:23 AM.
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Old 05-12-2008, 02:42 PM   #9
James R. Duwve
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Re: Translating an MRI into plain English

Andrew,
Thanks for the post. Sorry it took me so long to respond. Basically for the last two weeks I have been taking it easy on my shoulders. I guess it helps that my PT finally let me bend my knee and I am allowed to ride a bike. At least I feel like I'm getting a sweat going. (I had a bucket handle tear of my meniscus repaired 8 weeks ago).

As for the symptoms of my shoulder. I can't throw a ball of shoot a basket without the arm locking up. The pain seems to radiate from the back of my arm. If I do some warmup I can eventually throw with little pain. I actually had a really great day after taking Naproxen for 2 weeks after my knee surgery. Also, I can't reach across my neck and touch my opposite lat without pain in the top of my shoulder and the back of my arm. This has been going on for 10 or more years.

Also, when I was doing presses or push presses I would experience pain in the tricep area on the lockout. It would occur when i got close to my max lifts.

Recently, I have experienced pain when I do pushups. The pain would be in the front of the shoulder.

To compound matters I started seeing my PT because of pain in my left shoulder. After many days of painting and repainting a room with 18 foot ceilings, I was unable to lift my arm above parallel. After 8 weeks of therapy we made progress. However, it was when the left shoulder started feeling better that the right shoulder started acting up. I'm sure it has to do with years of correcting for imbalances.

Years ago before started crossfit and gave up bench presses as a main stay to my fitness program, my shoulders would get very sore in the front whenever I approached my max weights ( around 280#, I would have been about 170 and 44 years old).


Thanks

Jim
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