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Suffer shoulder drop and trapeziums atrophy after accident. Having pain in rheumatoid region with numbness and sever weakness. Help?

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General & Family Physician
Practicing since : 2006
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I am male ( 49 y old ) and i had accident in 2008 by lefting havey meterial and after 3 monthes my left shoulder dropped and trapezuis atrophy and i got winging scapula

2009 supracscapular nerve release
2010 bonr removed top of scapula
2011 XXXXXXX lange procedure
2012 spinal accessory nerve release

still i have winging scapula with sever pain in rhomboid regon ( minor & major )
with numbness and sever weakness.also i notice with my doctor when he stablize my back with chest i feel bater with god shoulder abductions.

He said i have to undergo with scapulothoracic arthodesis surgery????

Please advice

Thanks

User Selected Category : Bones, Muscles and Joints
Gender : Male Age : 49

MRI CONCLUSION:

Post Operative changes with metallic artifacts noted in suprascapular region with left rhomboid minor insertion transferred to left supraspinatous fossa



Mild edema noted in the region of the orgin of the left rhomboid major muscle from the spinous processes of T2 to T5 vertebra suggestive of muscle sprin



Distal supraspinatous tendinopathy



Small partial articular surface tear noted in the distal supraspinatous tendon



Hypetrophic changes in acromioclavicular joint



Mild glenohumeral joint effusion



What does that mean ? and what I need for my shoulder winging scapula?



thanks
Posted Sun, 18 Aug 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. Jay Patel 3 hours later
Hi,

I am dr XXXXXXX I will try my level best to address your concerns.

Based on the information it seems like you are wanting to know what is "scapulothoracic arthodesis surgery" and should you go for it, more over what do we mean by Mild glenohumeral joint effusion and shoulder winging scapula.

Let me address them as they appear in screen.

1) Scapulothoracic arthodesis surgery is the surgery that is used to bring the scapula back to as normal way as much as possible. I insist you to go for it, it will make your moves easy.

2) Now about MRI - REPORT - it gives an explanation in medical terms that the bone called scapula which appears as wing when we put two hands together, one of the side has the issue due to damage to nerve supply the muscle which regulates the movement of the bone.

In other words, - if we consider a lift/elevator, it works by motor and cable to move it up and down, in the same fashion in shoulder joints let consider the scapula bone as the main lift/elevator the motor is compared as muscle and the cable which rotates is compared to the nerves, now if the cable do not work properly that happens, it may have grease which makes it slip (which in our case is compare as Mild glenohumeral joint effusion, a collection of fluid around the joint).

Now Hypetrophic changes in acromioclavicular joint = means the joint has swollen so it will have hard time to move between the narrow passage.

Mild edema noted in the region of the orgin of the left rhomboid major muscle from the spinous processes of T2 to T5 vertebra suggestive of muscle sprain ---=means their is a fluid collection around the muscle and the bone at level of spines.

Distal supraspinatous tendinopathy-= means their is swelling and inflammation on the point insertion of muscles edge.

Small partial articular surface tear noted in the distal supraspinatous tendon =- their is tear of muscle's lower end.

All in all you do need the operation which will helps to fix the current issue.

Hope it helps. Still has any concerns please feel free to contact me.

Thanks for the query.
Dr XXXXXXX XXXXXXX




Above answer was peer-reviewed by
 
Follow-up: Suffer shoulder drop and trapeziums atrophy after accident. Having pain in rheumatoid region with numbness and sever weakness. Help? 12 minutes later
Thanks Doctor,

My question : Is the MRI showed enough to do the surgery?
 
 
Answered by Dr. Jay Patel 10 minutes later
Hi,

Welcome back, MRI is the best what we can have before opening the body up, more over the technique is so advance that its almost consider as gold standard for diagnosis of underlying issues before the opening the body.

So to answer your question MRI showed is enough evidences for an operation is "YES" It has more then enough evidence to be operated.

Only these " Post Operative changes with metallic artifacts noted in suprascapular region with left rhomboid minor insertion transferred to left supraspinatous fossa" is enough to operate to make it right, you have many more issues then one.

Thanks again, still free free to contact me in case of any concerns.

Dr XXXXXXX XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: Suffer shoulder drop and trapeziums atrophy after accident. Having pain in rheumatoid region with numbness and sever weakness. Help? 5 minutes later
Many thanks Doctor

Last question to close this case

what does mean clinical " Post Operative changes with metallic artifacts noted in suprascapular region with left rhomboid minor insertion transferred to left supraspinatous fossa"
 
 
Answered by Dr. Jay Patel 9 minutes later
Hi,

Their might be some metal used in previous operation to fix the issue earlier, which suppose to is found at the location of top of left shoulder joint where muscle named rhomboid minor (small square shape muscle ) is now getting to the upper sharper zone on scapula (wing shape bone). Basically the metal lock might have came off from its position / misplaced.

I can't be sure about that metal they are referring to because I do not have access to the previous operation details.

Hope it helps to clear few clouds. Still feel free to contact me in case of any concerns.

Thanks again for showing trust in me.
Dr. XXXXXXX XXXXXXX

Above answer was peer-reviewed by
 
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