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Can anyone please help to interpret my MRI

The reading says I have mild separation of Acromioclaviular joint with distance of 8mm & mild bone fragmentation as well as mild thinning of acromion. Large Subacromial/subdeltoid bursal effusion communicating with the should joint. Full thickness tear of supraspinatus tendon with minimal fibers remaining in continuity. Tendon retraction most pronounced anteriorly up to glenoid rim. Infraspinatus / subcapularis tendinosis without high grade tear. There is an impression of a small nondisplaced posterior labral tear. There is effacement of fat within the rotator interval. the inferior capsule appears s mildly thickened. Prominent subcutaneous fat. Biceps long head tendon grossly in continuity
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1081992 tn?1389903637
Hi, it sounds like you had an accident, or something that really pulled on the shoulder. Have you been told that you need surgery to repair the supraspinatus tendon?

You can see a graphic of the supraspinatus muscle here: https://www.physio-pedia.com/Supraspinatus

"supraspinatus" means being above the horizontal 'spine' or ridge on the shoulder blade.

Helpful - 0
1 Comments
My MD has indicated surgery, but due to our lovely US national health I am yet to get be seen by an orthopedist. My concern is also it has now been over a month since my injury. Do you think the system causing me a less likely ability to recover due to delay? I guess according to my MD the tendon has retracted quite far.
20841821 tn?1547942964
You definitely need to see a orthopedic surgeon who specializes in shoulders. Make sure your bring your CD with your images to the appointment. You can request this from the facility where you had your MRI, and it only takes them a few minutes to burn that for you. I am not sure why there would be a delay in getting your referral. Is the problem with your doctor not providing the referral, or your insurance company?
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4 Comments
Actually my MD & insurance company were efficient, however the ortho Doc's were pitiful.  I waited 2 1/2 weeks to see the Doc But he cancel the Friday before my Monday appointment saying he is no longer under contract. Then the second one in the plan well I am still waiting for his call back. I filed a grievance against both. Then a third doc's office said he did not take my insurance, but in fact he did it is a very long sad commentary of the system.
I was just curious. Yikes, what a nightmare! I think any of us who work in healthcare feel your pain. This time of year can also be crazy getting in to see a specialist because many people have met their deductible or out of pocket and schedule procedures. I will be praying you will find a great doctor who will get you all fixed up.
Thank you, same to your & your family. Do you know how critical this lapse in time is to the recovery of the retracted tendon? I am in some instances in "extreme"  pin I my arm & shoulder
Time is more critical in younger patients who have suffered an acute trauma. I am not sure of your age. I wouldn't delay it more than a few months. It may be beneficial to reach out to your insurance company to find orthopedic doctors in network that are near your geographical area.
1081992 tn?1389903637
"Do you think the system causing me a less likely ability to recover due to delay?"

That sure seems like a valid suspicion, but let's look at what evidence there is.

Here is the 'guideline' published by American Academy of Orthopaedic Surgeons. That seems to be their top group.
http://www.orthoguidelines.org/guideline-detail?id=1087
"Early surgical repair after acute injury is an option for patients with a rotator cuff tear."

Note right away that there was "LIMITED EVIDENCE" at the time the guideline was created, so we can't take it too seriously. Only 2 out of 4 stars. The most recent cite is only from 2008. It also points out the bad significance of fatty infiltration - which apparently you don't have..

The conclusion seems to be "It is thought that early repair of acute rotator cuff tears might mitigate the development of chronic tendon and muscle pathology and improve functional outcomes". But don't forget, that's weak: 2 out of 4 stars.

So let's look at this somewhat more recent: study:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3235289/
"The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears
Structural and clinical outcomes after repair of 42 shoulders"

...and let's for now just scroll way down to the Discussion: "In conclusion, acute traumatic tears of the rotator cuff in previously healthy shoulders can be repaired with an open technique, at least up to **3** months after the injury."

Otherwise, in older people with pre-existing degenerating tendons, the outcome seems somewhat worse.


That's a quick look by me, you should verify. Also, you might get a lot more from plunging into some long reading. Fortunately, the Full Text of that study is free.


I would guess that the muscle retracted very quickly. I recall a video of a bicep tear, you could see it move right up. The worry, if any, is degeneration. The 3 month figure given in that study should make you feel a little better, though.
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1 Comments
Thank you for your reply. I am now into my second month hopefully the eventual outcome will be positive.
1081992 tn?1389903637
Desimoto, you can also think seriously about undertaking various anti-inflammatory measures to try and prevent tissue degeneration as much as possible.

NSAIDs are a start, but there is more. Your MRI taken soon after the injury didn't show fatty deposition back then, but we don't know what's going on in there now.

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1 Comments
I have finally seen a Ortho surgeon. He has confirmed I have a massive tear and is in the process of fighting with the insurance company to get a surgery date. I have now been given two potent anti-inflammatory injections plus a regime of pills for same. Hopefully now the ball will start moving
1081992 tn?1389903637
That's great news, Desimoto. I hope you'll keep me updated on what happens next. I'm rooting for you, you've been through a lot of frustration and worse.

Are the pills you've been given prednisone or dexamethisone? What mg dosage? There are ways to lessen the side effects. That'd be especially meaningful if you are prone to high blood sugar.

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