Hello!

Is it just me or are reading the MRIs and interpreting the Drs findings confusing?

I am going to make an appointment next week at another Doctor and ask all the questions I have and hopefully get someone to show me where, on the MRI, they see the tear.

I obtained a copy on CD to bring to get a second opinion and I have looked numerous times and I don't see where the problems are.

Also the first doctor said that I have a Labral tear from 9 - 6. Told me to look up Shoulder dislocation, Labral tear, SLAP tear, bankart. I have been reading and am still a bit confused. A SLAP tear is a type of labral tear? and a bankart is also a type of Labral tear, or is a bankart a sub type of SLAP?

My Doctor only talked to me concerned about the tear but the reading of the MRI talked about other things.

QUOTE:
Hyperintensity and mild thinning affecting the bursal surface of the supraspinatus tendon are present. The remainder of the rotator cuff is intact. There is mild diffuse teres minor edema suggesting denervation injury. minimal abnormal fluid is present within the subacromial/subdeltoid bursa. minor hypertrophic changes of the acromioclavicular joint are noted.

No Hill Sachs or bony Bankart fractures are demonstrated. However, complex linear signal extending through the labrum superiorly indicating labral tear is present. The tear propagates to involve the entire anterior labrum and to involve the labrum posterosuperiorly. The tendon of the long head of the biceps is intact. There is no glenohumeral effusion.

Impression:

1. Supraspinatus tendinosis and mild partial thickness bursal surface tear.
2. Milc AC arthrosis and mild subacromial/subdeltoid bursitis.
3. Superior labral tear with anterior and posterosuperior extension.
4. Mild diffuse teres minor edema suggesting denervation injury.

I'll have to be more prepared with questions when I go for a second opinion.

Thanks for listening

Re: MRI understanding:

Number 1 and 2 suggest impingment syndrome, A/C arthritis.

Number 3: self-explanatory, SLAP tear

Number 4: suggestive denervation means you should consult a neurologist to rule out possible cervical radiculopathy (pinched nerve in neck) vs. peripheral neuropathy, i.e. suprascapular nerve impingment, etc.

All of this is suggestive only as MRI sensitivity is around 70-75% (misses 25-30% of SLAP tears) with MR arthrogram in the 90+% for SLAP tear. Tendonosis appears not to be present but arthroscopic exam is the bottom line...

Get a GOOD ortho!

Hope it helps!

Correction! supraspinatus tendinosis is present which suggest at least tendonitis of the same. Still, get a good ortho opinion.

Thanks Cavitator.

I have an appointment at a another Ortho for a second opinion, on May 8th.

I may even see a third Doctor this week if I can get an appointment. Can't hurt to see a few different doctors to see if they all tell me the same thing.

Jennifer, I saw three as well. Diagnostically, they all said about the same; surgical repair (which is scheduled next Wednesday).

The third was WAY out there. He didn't even read his own intake forms to see that I am coming off a cervical fusion 3 months ago or ask about the car accident that pre-dated all this mess!

His treatment was strange too, I thought, just stick a cortisone shot in there every 4 months until it blows-yeah, like that'l work!

Go with the common opinion(s) that hopefully, are well-informed, mainstream and represent the most conservative approach treatment-wise!

Best to you, Brian

Thanks Cavitator, best of luck on your sugery this week.

Jennifer.Sari