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Ultrasound Of Wrists Shows Carpal Tunnel Syndrome. Cortisone Injection Good? Want Second Opinion

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Posted on Fri, 12 Apr 2013
Question: Hi dr XXXXXXX , i hope you remember me last time i told you i will get back to you after may mri scan is done and it is mri of right shoulder- Shows mild osteoarthritis of the AC joint.There is hetarogeneous increased signal of the supraspinatus tendon consistent with mild tendinopathy.Mild subacromial subdeltoid fluid in keeping with bursitis is seen. No other abnormality.
Impression:
Mild subacromial subdeltoid bursitis.Mild supraspinatus thendinophaty.No evidence of rotetor cuff tear.Mild degerative changes of the AC joint.

I did ultrasaund of may wirst both hands and results is:
Bilateral hand and wrist ultrasaund
Clinical:Query right carpal tunnel syndrome.
Right median nerve measures 12mm2 and left 10mm2.
Flexor and extensor tendons unremarkable.No ganglion.
Interpretation:
Imaging findings borderline suggestive for carpal tunnel syndrome in right side.

Can you please go to may previos diagnose and colect and compere all may results and give me your picture i have this question:
1)- shuld i do more test doctor said she is suprise there is not tears on it maybe mri scan with IV or so .... also i read abaut cortizon injection in medical information that is not good idea toget one beafore mri specificly at Ac joint degeneration or so..
2)I request my cd of mri can i get you same or who to read agein they said secund opinion will not hurt you?
3)i' m not sleeping at oll in last 7 days like alive zomby i no i distrube may sleep going tru past bat i did still sleep what is this naw??
4)I ask may gp 2 months ago to give me ultrasaund of wrist after may fiziotherapeut told me i have probably carpal tunnel she did nothing last 2 weaks she is awey then i ask doctor ( canging her at present time) she did it and you see also fiziother.. Told me somthing abaut elbovw i ask can do that she said no nead may elbow hurting from frst day so mach and all way up to shoulder and araun masels part of hand and XXXXXXX from elbow to wrist.Wory way she did not do more told me jast to change therapist??
Sorry i ' m terebole bat please me as the best you can like you did so before include not jast my life this is workrelated.
Thank you
doctor
Answered by Dr. Ganesh Sanap (17 hours later)
Hi, welcome back and thanks for writing back.
I have gone through your previous question and new reports.
First of all I will tell you have done perfect investigations. No need to further investigation now.
Now regarding MRI- There is tendinosis in supraspinatous tendon with fluid and AC joint arthropathy. This is cause you are having pain in shoulder and cervical region. For this operation is not necessary. Physiotherapy will give you definitely relief. Corticosteroid injections will not affect the imaging pattern at all whether given before or after the procedure.
You can get your mri CR to me for second opinion. For that you need to write to customer care support.
If you are having severe pain which is disturbing sleep then you need some strong analgesics like tramadol.
Regarding carpel tunnel syndrome - ultrasonography is sufficient now. Ask your physiotherapists for exercises regarding same. If you are having pain in elbow then some exercise is wrong. Ask her to change it.

Both conditions are easily treatable with drugs like steroids and physiotherapy. So you don't need to worry too much now.

Hopefully I have answered your query. If you have further concern, please let me know.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ganesh Sanap (4 hours later)
Thank you doctor, that fiuid couse may neck problem should i do more then x- XXXXXXX on the neck ? Is this curibole condishen or going to stay with me like if it is reacuring problem.Is may headics and somttims leg and nee pain caming from this? Should i not ask for may elbow ( right side) any ultrasaund or so same vith wrist . My medication are cymbalta and vimovo.
Is this going awey or staying with me and when i going to age more will be more problems .Thank you for evrithing .
doctor
Answered by Dr. Ganesh Sanap (1 hour later)
Hi, welcome back.
Be relax. That fluid is reactive only. It will disappeared completely once healing starts. It will decrease with physiotherapy and medications. Your medicine are correct you just continue it.
No need to do any further investigation now. No need to evaluate elbow joint. You may have problem in elbow but it is due compensatory overuse. Shoulder and wrist pain causes elbow overuse.
No need to worry about that.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Ganesh Sanap

Radiologist

Practicing since :2007

Answered : 561 Questions

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Ultrasound Of Wrists Shows Carpal Tunnel Syndrome. Cortisone Injection Good? Want Second Opinion

Hi, welcome back and thanks for writing back.
I have gone through your previous question and new reports.
First of all I will tell you have done perfect investigations. No need to further investigation now.
Now regarding MRI- There is tendinosis in supraspinatous tendon with fluid and AC joint arthropathy. This is cause you are having pain in shoulder and cervical region. For this operation is not necessary. Physiotherapy will give you definitely relief. Corticosteroid injections will not affect the imaging pattern at all whether given before or after the procedure.
You can get your mri CR to me for second opinion. For that you need to write to customer care support.
If you are having severe pain which is disturbing sleep then you need some strong analgesics like tramadol.
Regarding carpel tunnel syndrome - ultrasonography is sufficient now. Ask your physiotherapists for exercises regarding same. If you are having pain in elbow then some exercise is wrong. Ask her to change it.

Both conditions are easily treatable with drugs like steroids and physiotherapy. So you don't need to worry too much now.

Hopefully I have answered your query. If you have further concern, please let me know.

Regards.