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MRI shows inflammation in shoulder. Suggested surgery. Arm feels close to body. Cause?

Jul 2013
User rating for this question
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
I am doing pt for shoulder. Felt as though something had torn. MRI shows inflamation. Dr. wants to go in in a few weeks to "clean it up" and shave off some bone from impingment. Do not have full rom even passive arm cannot be moved in certain positions feel like bone will break or pop. My pt thinks labral tear not showing on MRI that will be found during surgery. Problem is fullness of armpit. I do not have an armpit area anymore. My arm feels too close to my body and it is full and swollen. Difficult to wash etc. Has one painful area deep straight up towards shoulder. Told Dr. he says get mamogram. I told him no this happened imediately in one day. It is misshaped even when I lift my arm up with the other arm to try and get under it in the shower. For a few days had to put a folded cloth in armpit to cushion it as it felt awful. Any ideas what i could have hurt to cause this?
Posted Wed, 16 Oct 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 19 minutes later
Brief Answer:
It could be Impingement syndrome.

Detailed Answer:
Hi, thanks for writing to XXXXXXX

Based on the description of the symptoms, the most likely cause might be Impingement syndrome which causes painful restriction of movements of the shoulder after certain degree of motion in the joint.

This condition can be diagnosed by clinical examination and MRI scan of the involved shoulder.

MRI scan will definitely pick up the Labral tears, if they are present.

I feel that the swelling in your arm pit could be due to the synovial effusion in the joint which is the result of inflammatory process in the joint secondary to impingement.

Arthroscopy is both a diagnostic (identifying the problem) as well as therapeutic (treating the problem) tool for all the shoulder pathologies.

So, I suggest you to consult an Arthroscopic surgeon experienced in shoulder arthroscopy for a detailed evaluation and further management.

Temporary management of this condition involves -
* Rest and activity modification by avoiding overhead activities
* Medications like Advil or Aleve will help in reducing pain & inflammation
* Stretching exercises to improve range of motion are very helpful. If you have difficulty reaching behind your back, you may have developed tightness of the posterior capsule of the shoulder (capsule refers to the inner lining of the shoulder and posterior refers to the back of the shoulder). Specific stretching of the posterior capsule can be very effective in relieving pain in the shoulder.
* If rest, medications and physical therapy do not relieve your pain, an injection of a local anesthetic and a cortisone preparation may be helpful.

Hope I have addressed your query. Happy to help further

Above answer was peer-reviewed by
Follow-up: MRI shows inflammation in shoulder. Suggested surgery. Arm feels close to body. Cause? 7 hours later
Should have mentioned--This all came about after being treated for sometime for different shoulder injuries by my chiropractor. I have a history of being a painter-exterior and interior, have installed hardwood floors, and done general demo and rehab on homes that I flip or rent out. I had been treated for overuse and then had my arm pulled and twisted by someone--at that time I felt a deep seering pain. Felt the same pain two weeks later when reaching up to swat a fly on a ceiling light with a backhand motion-seering pain deep in shoulder fell to floor. Then complained to chiro that my arm would not longer bend behind my head when doing sit ups or go behind my back to hook bra-also random pain when I do small things like reaching and flipping my wrist. Final straw--pulled on a locked door felt seering pain and shoulder bascially went into spasms. Could not move it at all on my own or with my other hand because of pain. Went to ortho who took xray and said impingement syndrome and bone spurs. Had cortisone shot which made the pain worse. Had to carry arm around could not move it unbearable pain. Now Dr saying MRI shows inflamation and he wants to go in in 5 weeks to clean it up after I do pt. Had almost full range of motion until final pull on that locked door and then no armpit area the next day. My husband had shoulder surgery in the past and his mri also showed only inflamation and bone spurs he wound up with full inscision and tons of work done. Physical therapist says inflamation hides a lot on MRI's. If-if I had torn something would that explain armpit fullness and then the feeling now of something in the crease-deep? I can use my arm for everything in the handshake position but cannot move it bent out to the side like to throw a ball.
Answered by Dr. K. Naga Ravi Prasad 4 hours later
Brief Answer:
I suggest Arthroscopic evaluation.

Detailed Answer:
Hi, Nice to hear from you.

From the given description, there is a likely possibility of "Rotator cuff tendinitis" associated with Impingement syndrome causing you the typical symptoms.

If some soft tissue (tendon, ligament, capsule, labrum etc) is injured in the joint, effusion (fluid collection) is a normal joint reaction which is the cause of your fullness.

Even the cortisone shots have failed to provide you pain relief, I highly recommend Arthroscopic evaluation of your shoulder, which serves both diagnostic and therapeutic purpose.

As arthroscopic examination involves direct visualization of the inside of the joint, there will be nothing that can be missed.

Hope I have justified your query. Have a great day
Above answer was peer-reviewed by
Follow-up: MRI shows inflammation in shoulder. Suggested surgery. Arm feels close to body. Cause? 10 hours later
Dr says he will be doing surgery to shave off bones and to "clean up" from the inflamation-small tears. He has only seen me lift my arm has done no full rom on me only looking at test results. That is why my physical therapist who is hands on thinks things will show at surgery such as a slap tear. Thank you for your info on the possiblility of fluid even if it is a labral injury. Is there a way I can help get rid of the fluid deep in my armpit quicker if it is there? Again thank you so much.
Answered by Dr. K. Naga Ravi Prasad 42 minutes later
Brief Answer:
Everything will settle down after Arthroscopy.

Detailed Answer:
Hi, As I said earlier, arthroscopy is both a diagnostic and therapeutic tool which involves cleaning of all the devitalised tissue and performing repairs of the damaged tissues. So, overall, it addresses all your issues in the shoulder thereby providing significant improvement in your condition.

As long as the inflammation stays inside the shoulder joint, the fluid in the joint keeps collecting. Antiinflammatory agents like Advil or Aleve may help in reducing the pain & inflammation to certain extent and thereby may lessen the swelling minimally.

Hope I made it clear. Good day
Above answer was peer-reviewed by
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