Just recived report on following. what treatment might I recieve, or do you think surgery will be required? Doesn't sound good to me!
STUDY : MRI Shoulder (Left) w/o contrast - 0000
CLINICAL HISTORY: Fall, severe shoulder pain.
TECHNIQUE: MRI left shoulder without contrast. Study performed on the open low-field strength magnet.
FINDINGS: There is full thickness tear of the supraspinatus tendon occurring at the site of insertion over a segment of approximately 15 mm anterior to posterior with 10 mm of tendon retraction. Partial thickness tear continues all the way into the infraspinatus posterior from this location seen as thinning and increased signal along the articular surface. The majority of this tear is 50% thickness or greater and upwards of 2 cm medial to lateral. There is minimal muscle atrophy and fatty infiltration of the supraspinatus and infraspinatus. Subscapularis remains intact with tendinopathy and perhaps a small interstitial partial thickness tear at site of insertion. No retraction.
SUPRASPINATUS OUTLET: There is moderate hypertrophic and mild inflammatory change at the acromioclavicular joint. Distal clavicle is seen to have mass effect upon the distal supraspinatus muscle, correlate for probable impingement. There is mild subacromial-subdeltoid bursitis.
LONG HEAD BICEPS TENDON: Tendon is slightly thinned distally in the bicipital groove. Tendon otherwise appears to be intact.
LABRUM: Labrum not well seen by this study. There is ill-defined appearance particularly at the inferior aspect of labrum where tear to include the anterior-inferior labroligamentous complex not excluded. Correlate for any related instability.
BONE: Marrow edema is seen along the greater tuberosity extending deeper with a somewhat crescentic appearance, possibly an area of contusion or most likely osteonecrosis.
IMPRESSION: Large area of mixed full thickness and partial thickness tear of the infraspinatus and supraspinatus. Additional findings as above.
Pat Cherry, MD
Electronic Signature
DD: 04/30/2013/DT: 04/30/2013
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(THE ABOVE REPORT IS A PRELIMINARY DRAFT IF IT DOES NOT CONTAIN AN ELECTRONIC SIGNATURE)