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What Does This MRI Report Indicate?

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Posted on Fri, 7 Jul 2017
Question: I have had significant-sometimes debilitating (on and off) pain for approx 8 weeks, with limited range of motion. I cannot lift my arm above my shoulder, nor can I execute any overhead maneuvers without severe pain. I have had 8 PT sessions, which seem to intensify the pain (especially the 2 days following PT).

Below are the result notes from my MRI. Please clarify this diagnosis in clear terms, including prognosis and suggested treatment plan.

IMPRESSION:
1. Intrasubstance tear of the subscapularis tendon. No full-thickness tear. No muscle atrophy or infiltration.
2. Mild tendinosis involving the suprasinous and infraspinatus tendons without discreet or full-thickness tear.
3. No joint effusion.
4. No bursitis.

There is mild intrasubstance intermediate signal involving the supraspinous and infraspinatus tendons compatible with tendinosis. No thickening of the tendons. No full-thickness tear.

There is a small amount of fluid signal in the distal suscapularis tendon. This appears on images 13-16 of series 6 of the sagittal sequence as well as series 3 on the axial sequence. It appears to be in the substance of the tendon. (all other comments indicate normal or unremarkable).
doctor
Answered by Dr. Kathy Robinson (1 hour later)
Brief Answer:
tendinosis is degenerative damage

Detailed Answer:
Hello,
The good news is that the MRI did not show any full thickness tears. However, knowing this does not help with the pain. Tendinosis is a degenerative disease of the tendons. When the tendons are not working properly there can be pain in the joints. There is not a lot of inflammation so anti-inflammatories or steroid injections probably will not be helpful.
The PT should work but it may take time. You could also try warm compresses or ultrasound therapy. Some PTs do ultrasound therapy but others do not. Some doctors can do it in the office. Also electrical stimulation with acupuncture may give you some relief.
Make sure you are staying well hydrated. Glucosamine at 1500 mg per day may help but you would need to take it for a month to see results.
I hope you get some relief soon
Dr. Robinson
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kathy Robinson (28 minutes later)
I'm more interested in the first item mentioned:

Intrasubstance tear of the subscapularis tendon
doctor
Answered by Dr. Kathy Robinson (16 hours later)
Brief Answer:
tears

Detailed Answer:
Hello,
Tendon tears happen in tendons that are damaged from trauma or repetitive strain or from tendons that have degenerative changes. Intrasubstance means within the body of the tendon.
The subscapularis muscle runs across your back under the scapula (shoulder blade). Its tendon attaches it to the humeral head. Again, as with the other damage, this is not a complete tear, just a small tear within the tendon.
Tendons have a poor blood supply and so take a long time to heal.
Whenever the tear is not complete there is no surgical repair that will help.
The therapies listed above are your best bet for treatment and pain relief.
Regards,
Dr. Robinson
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Kathy Robinson

General & Family Physician

Practicing since :1989

Answered : 3535 Questions

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What Does This MRI Report Indicate?

Brief Answer: tendinosis is degenerative damage Detailed Answer: Hello, The good news is that the MRI did not show any full thickness tears. However, knowing this does not help with the pain. Tendinosis is a degenerative disease of the tendons. When the tendons are not working properly there can be pain in the joints. There is not a lot of inflammation so anti-inflammatories or steroid injections probably will not be helpful. The PT should work but it may take time. You could also try warm compresses or ultrasound therapy. Some PTs do ultrasound therapy but others do not. Some doctors can do it in the office. Also electrical stimulation with acupuncture may give you some relief. Make sure you are staying well hydrated. Glucosamine at 1500 mg per day may help but you would need to take it for a month to see results. I hope you get some relief soon Dr. Robinson