Is there a Dr in the house to interpret my MRI?

OP
CRJR45

CRJR45

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Please, whatever you do, when you meet with your Dr. next week explain how you've already gotten very good advice from strangers on the internet.
Hmmm , I thought I received great input ? My condition was explained completely , and it was much more fun than Googling it . The gonorrhea one was hilarious .
And there are no strangers here , just people I've yet to meet .... 😂
 
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I'm not a medical doctor, but unfortunately have personal experience, and a good friend that went through worse. When you have a complete tear, the muscle begins to atrophy and shrink. The longer surgical repair is delayed, the more the muscle shrinks; subsequently it may no longer be possible to reattach it directly. If this is the case they attach a "balloon " i.e., elastic to restore function - mobility of the arm. However, they cannot restore strength with the latter method, as such, use if the arm is limited. My good friend experienced the latter, she will never have close to full use of that one arm again. That arm is very significantly reduced in strength. She can lift about 5 pounds once. She is exceptionally limited in the use of that arm on typical daily activites and must rest it often (imobilize it on and off throught the day). In her case, an MRI was not originally approved and she was sent to physical therapy which resulted in further extensive irreparable damage, associated directly with the subsequent delay in surgical repair.

In short, do not nor accept any delays in surgical repair, and make sure you have the best orthopedic surgeon you can find.

I've had both of my shoulders surgically repaired, my outcome is a good one. I have full use of both. My strength is not what it was, but I have no real complaints. My only complaints are directly related to rheumatoid and osteoarthritis, not my surgeries.
 

grfox92

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You (completely) tore two of the 4 muslces that make up your rotator cuff, one of the others is fine, and the last one is partially torn. One of the biceps tendons has some swelling and inflammation at the least, also possibly torn. Labrum (the cartilage ring in your shoulder) has a tear in the front of it. Lots of swelling, some arthritis. Acromion (part of your shoulder blade) is normal. The muscles of the involved tendons have started to shrink.
Listen to this guy.

Sent from my SM-G990U using Tapatalk
 

Nevwild

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Type this prompt into chat gpt, followed by the notes you shared.

I just got an mri of my shoulder. These are the notes from the doctor. Please explain them to me like I’m a layman.
 

ztc92

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You (completely) tore two of the 4 muslces that make up your rotator cuff, one of the others is fine, and the last one is partially torn. One of the biceps tendons has some swelling and inflammation at the least, also possibly torn. Labrum (the cartilage ring in your shoulder) has a tear in the front of it. Lots of swelling, some arthritis. Acromion (part of your shoulder blade) is normal. The muscles of the involved tendons have started to shrink.

Family doctor with extra training in sports medicine and orthopedics here. This comment above is an excellent summary. You’ve gotten some other good advice along the way as well.

A few other points you should consider before your visit with the surgeon:

- Be sure to describe your activity level and expectations very clearly. Shoulder surgery is not one-size fits all and how best to repair these multiple injuries with greatly depend on your age and level of function. If young and healthy, you’d likely want to fix everything. If 50-65 and moderately active, probably fix the muscle tears but could leave the labrum and biceps alone. If 65+ and not very active, maybe you just do rehab and wait to get a shoulder replacement when arthritis worsens.

- I agree with others to consider a surgeon who has completed a fellowship in upper extremity. This is more important if fixing the labrum and/or biceps tendon. Most general orthopedists will be comfortable with the rotator cuff tear and any potential shoulder replacement (not saying you need that). If this was straightforward I’d say general ortho sounds fine but given multiple injuries over a long time period, I’d find an upper extremity sub-specialist, if possible.

- Next to finding a good surgeon, the next most important factor is finding a good PT to guide you through rehab. Ask around, try to figure out where athletes and young, active people are going. Definitely ask your surgeon what they recommend for PT referral but take it with a grain of salt, especially if it’s part of their company/employer. Consider asking where they’d send a friend or family member if they needed PT after shoulder surgery.

- Speaking of PT and recovery after surgery, I mean this in jest but please take it to heart, “You are not special”. What I mean by that is the surgery and subsequent rehab protocols are based on decades of research to help achieve the best outcome with the least risk. I see so many patients who think they’re special and either push themselves too hard, too fast and cause the surgical repair to fail, or somehow think there body will magically heal without them putting in any work, only to end up frustrated when they don’t regain full strength of range of motion. Please, please, please listen to your surgeon and PT when they talk you through the expected progression of rehab after surgery.

Best of luck!
 
OP
CRJR45

CRJR45

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Family doctor with extra training in sports medicine and orthopedics here. This comment above is an excellent summary. You’ve gotten some other good advice along the way as well.

A few other points you should consider before your visit with the surgeon:

- Be sure to describe your activity level and expectations very clearly. Shoulder surgery is not one-size fits all and how best to repair these multiple injuries with greatly depend on your age and level of function. If young and healthy, you’d likely want to fix everything. If 50-65 and moderately active, probably fix the muscle tears but could leave the labrum and biceps alone. If 65+ and not very active, maybe you just do rehab and wait to get a shoulder replacement when arthritis worsens.

- I agree with others to consider a surgeon who has completed a fellowship in upper extremity. This is more important if fixing the labrum and/or biceps tendon. Most general orthopedists will be comfortable with the rotator cuff tear and any potential shoulder replacement (not saying you need that). If this was straightforward I’d say general ortho sounds fine but given multiple injuries over a long time period, I’d find an upper extremity sub-specialist, if possible.

- Next to finding a good surgeon, the next most important factor is finding a good PT to guide you through rehab. Ask around, try to figure out where athletes and young, active people are going. Definitely ask your surgeon what they recommend for PT referral but take it with a grain of salt, especially if it’s part of their company/employer. Consider asking where they’d send a friend or family member if they needed PT after shoulder surgery.

- Speaking of PT and recovery after surgery, I mean this in jest but please take it to heart, “You are not special”. What I mean by that is the surgery and subsequent rehab protocols are based on decades of research to help achieve the best outcome with the least risk. I see so many patients who think they’re special and either push themselves too hard, too fast and cause the surgical repair to fail, or somehow think there body will magically heal without them putting in any work, only to end up frustrated when they don’t regain full strength of range of motion. Please, please, please listen to your surgeon and PT when they talk you through the expected progression of rehab after surgery.

Best of luck!
Thank you !
I have an appt with the orthopedic Dr tomorrow and my wife has a couple specialists pick out , one that does a reverse replacement ?

And yes I've already received bad advice on the PT , my brother has been through this and recommended- "Whatever they tell you , double it , if they say ten reps , do twenty " LOL

As much as I hate PT , I will comply .
 
OP
CRJR45

CRJR45

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I'd love to interpret your MRI, but as much as I've searched for it.....I can't find it posted anywhere in this thread.
What am I missing ?

Full-thickness complete tears of the supraspinatus and infraspinatus with musculotendinous retraction. The teres minor is within normal limits. Partial tears of the subscapularis.The long biceps tendon is within the bicipital groove but the tendon appears to be enlarged with some increased signal consistent with tendinosis, possible partial tear.Evaluation of the glenohumeral joint demonstrates tear of the anterior labrum. There is moderate joint effusion communicating with fluid in subacromial/subdeltoid bursa.Hypertrophic degenerative change of the acromioclavicular joint with some impression on the underlying supraspinatus. Type II acromion.Evaluation of marrow signal within the visualized bones demonstrates subchondral cystic change/marrow edema at the previous supraspinatus/supraspinatus insertions.There is some element of atrophy of the muscles of the RIGHT shoulder/rotator cuff.
 
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