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Having soreness in arm. MRI of shoulder and knee done. What does the reports suggest?

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Feb 2014
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Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
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Question
Read an diagnose an mri scan of left shoulder and left knee. Doctors not giving us answers. Thanks.
Posted Tue, 30 Oct 2012 in Bones, Muscles and Joints
 
 
Answered by Dr. Saurabh Gupta 31 minutes later
Hello XXXXXXX,

Thank for writing in.

Please do upload the reports so that I would be in a better position to help. I would also like to know what is your exact complain in your shoulder and knee.

Awaiting your reply.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having soreness in arm. MRI of shoulder and knee done. What does the reports suggest? 32 hours later
Okay i will start with the left shoulder

My father complained about a sore left arm in XXXXXXX 2012 and had difficulty putting a seat belt on. He had been digging in the garden previously. He thinks that the digging hurt his arm.

He went to a physio about his left arm at the end of XXXXXXX 2012 and the physio treated my father for tennis elbow and told him to ice it. In the first week of july whilst my father was on holidays in Spain, he attended a physio again. The physio massaged his left arm. The forearm still did not heal. Constant pain in his left forearm. Then in early August he went to a doctor and asked him "would he inject a steroid into the arm to heal it"? The doctor said NO to the injection! The doctor then thought the pain was occurring in his left shoulder and prescribed my father anti-inflammatories (Difene). The Difene did not work at all. Still pain. At this stage my father had tenderness in his shoulder. My father then went to our family doctor. The doctor referred my dad to a orthapedic surgeon. At the end of August 2012, the surgeon examined my fathers arm and he said he was going to inject him in the shoulder. My father went on another holiday on 22nd August 2012 and his pain was almost gone at this stage. This was the best time for his shoulder. Coming back from his holiday my father went to the surgeon. The surgeon said the pain would not clear up unless he injected it. He injected my fathers left shoulder twice. My father was in constant pain from this night onwards. No pain killers or anti-inflammatories would take the pain away. Difene and oxynorm were prescribed.

After one week of this, my father demanded an MRI scan. Here i enclose the scan.
My father asked the orthapedic surgeon "what are you treating me for"? He responded "im treating your rotator cuff"!! My father is in constant pain now. The steroid injections are not killing his pain and the pain killers do not work. Please help me to find a solution.
 
 
Answered by Dr. Saurabh Gupta 11 hours later
Hello,

Thanks for your query again.

I have gone through your uploaded reports in detail.

Your father might be suffering from rotator cuff tear in left shoulder.

I would also like to know whether there is weakness of shoulder present, difficulty in lifting the arm overhead.

Physiotherapy, anti inflammatory pain medication and steroid injections are given to reduce the inflammation and strengthen the uninjured muscle around the shoulder to compensate for the torn muscle.

Mostly these tears are treated in this way. So if your father had no any relief after these measures, then you have to discuss with your orthopaedic surgeon regarding surgical option.

In surgery rotator cuff repair done by-
1) Arthoscopic surgery
2) Open surgery
3) Mini-open surgery

In addition other surgical treatment-
1) Debridement (removal of loose and damaged tendon or bone)
2) Acromioplasty (removing some of bone underneath the shoulder blade)

Hope I have answered your query. Let me know if you have any more concern.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having soreness in arm. MRI of shoulder and knee done. What does the reports suggest? 11 hours later
My apologies. I left out a crucial part of the story. When the surgeon seen the MRI scan he brought my father in and injected my father again for the third time (21st Sept). He injected him in the side of his left shoulder. My father was instantly in agonising pain and was taken into the recovery room. 6 hours after the injection, the surgeon drilled 3 holes in my fathers shoulder 1 in the front and 2 in the back. The surgeon said he washed/cleaned out the shoulder with the use of a camera and said he could see nothing else that was wrong. My father in the initial stages could always lift his arm overhead but now he finds it difficult.
 
 
Answered by Dr. Saurabh Gupta 3 hours later
Hello XXXXXXX

Thanks for your writing back to us.
According to your description, your surgeon had done arthroscopic debridement in your father's shoulder.

Hope I answered your query. Let me know if you have more concerns

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having soreness in arm. MRI of shoulder and knee done. What does the reports suggest? 11 hours later
Okay but he is still in pain now. Nothing has worked for him. What is your reccommendations?
 
 
Answered by Dr. Saurabh Gupta 19 hours later
Hello,

Thanks for your query again.

As your surgeon had done the diagnostic arthroscopy and thorough lavage of the shoulder and according to that there is no much pathology is present.

This pain will subside with anti-inflammatory drugs and your father has to continue physiotherapy to regaining full range of motion and strength the shoulder muscles.

Hope I have answered your query.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having soreness in arm. MRI of shoulder and knee done. What does the reports suggest? 47 minutes later
Ok, we have exhausted all options and we are desperate for answers. My father keeps asking me what i can do? I want to help him. He woke up this morning and now his pain has worsened. He is asking me if i think his shoulder is swollen. I dont know. He says the pain is coming from where the stitches are. ????? please help me.
 
 
Answered by Dr. Saurabh Gupta 21 hours later
Hello,

I apologize for the delayed response.

I understand your father is in pain, but without a clinical examination, I am unable to comment about its cause now. Perhaps the stitch site may be inflamed / infected.

As the arthroscopy revealed no serious pathology and the pain worsened after the procedure, I speculate that wound might be inflamed. Ideally it is best to report the issue to the treating surgeon. He/she can prescribe him stronger analgesics. Antibiotics would be needed if there are evidences of infection.

Hope I have answered your query. Let me know if you have other enquiries.

Regards
Above answer was peer-reviewed by
 
Follow-up: Having soreness in arm. MRI of shoulder and knee done. What does the reports suggest? 4 days later
My father is now currently staying at a private hospital. I took him up to hospital on the morning that he complained of pain in his shoulder (asking me if i thought it was swollen). On taking him up to the hospital, the surgeon examined my fathers left shoulder and said there must be a very low grade infection in his shoulder. He said this was very rare like 1 in 10,000 cases. I think the surgeon doesnt know what he is at. I think he has caused my fathers problem and is now desperately trying to fix it. The nurses done an aspiration test in his shoulder for further analysis and took his bloods. The bloods showed that there was inflammatories present ?? They told my father that they were going to keep him for a a week to observe him. I left my father in hospital.
The nurses put in a PICC line in his right arm to administer antibiotics intravenously. He was in immediate pain as the PICC line was inserted. Constant pain, they had to stop the fluids on the PICC line and restart several times. But my father was in constant pain all throughout. My father complained about his hospital clothing getting tight especially on the arm that the PICC line was inserted (upper). The nurses did not listen to him and joked "tight clothing, you have big muscles"!! My father was given more anti-biotics via PICC line and he was in agony. He then said again "these clothes are getting tight"!! The nurses listened but passed no remarks. My father immediately ripped off his hospital gown and his right arm was inflated like a balloon. The nurses were dumbfounded. The PICC line was not inserted properly in my opinion. They removed the PICC line and made several attempts to get a vein in his right back of hand.
Yesterday morning my father went in for more surgery. I think they called it Arthroscopic Subacromial Decompression. They have already performed this procedure stating they removed a chip of a bone off his shoulder. The most recent xrays only show slight calcification in the left shoulder. ??? The nurses and doctors are very negligent. Cannot give us answers. Constantly using words like bursitis, impingement, inflammation, infection. Why does my fathers pain not go away?? PLEASE HELP!! NO MORE PAIN, PLEASE!!!!!
 
 
Answered by Dr. Saurabh Gupta 22 hours later
Hello,

Thanks for writing in again.

I can understand your anxiety.........Your father is still in pain.

There is low-grade infection present as stated by your surgeon after clinical examination and investigation like analysis of aspirate from shoulder and blood tests.

For this IV antibiotics are given in hospital.

In description it seems that you might not happy with behavior of nurses as they had not given proper attention to your father complains. Some time it is difficult to access vein in some persons due to swelling. Do not get irritated, these things happen some time. Forget this............& be calm.

Now your surgeon’s plan for Arthroscopic subacromial decompression meaning that removal of some bone to create more space for Rotator cuff tendons so that pinching of rotator cuff muscles by bone spurs get relived.

So be calm and show faith in your treating surgeon. This procedure might relief your father pain and anxiety.

Wishing your father good health.

Regards.
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Follow-up: Having soreness in arm. MRI of shoulder and knee done. What does the reports suggest? 8 hours later
What would have caused the infection??? Will the shoulder get better? He is going for his third surgery this Friday?? :-( Something about cleaning out. Thanks.
 
 
Answered by Dr. Saurabh Gupta 19 hours later
Hello,

Infection might happen either due to weak immunity of your father or external environmental condition, might be contaminated during previous surgery.

Do not worry! Your father will get better soon.

Go for surgery as advised by your surgeon.

Hope I have answered your query. Let me know if you have more concerns.

Warm Regards.
Above answer was peer-reviewed by
 
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