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Suggest treatment for swollen and painful shoulder

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Posted on Wed, 7 Sep 2016
Question: So I have had torn labrum a in the past I have an appointment with a ortho tomorrow to
Order a Angio mri. My last time I had an allegric reaction to the XXXXXXX My shoulder was horrible painful and swollen and my airway started to close off. They told me I shouldn't have it again. Yet they need it to see a tear in the labrum. They thought of bringing in a Anesiologist to intubated me maintain my airway give me pain Meds and monitor me during the procedure. What should I tell my doctor what can I do?
doctor
Answered by Dr. Vivek Chail (45 minutes later)
Brief Answer:
There are MRI angiography techniques which do not require XXXXXXX injection

Detailed Answer:
Hi,
Thanks for writing in.

Contrast reactions are very rare and unfortunately you have had it in earlier. You must not take any similar XXXXXXX injection as it can adversely affect your health.

However MRI angiography techniques are available which do not require the use of a contrast XXXXXXX

Therefore I suggest you discuss with your doctor and the radiologist and technologist request if they can do MRI angiography using a technique which does not require XXXXXXX injection.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (3 minutes later)
I have had an mri angio without XXXXXXX before but they could not het a good reading used to be a ballroom danver i have labrum tear surgeries. The mri angio i had without it they couldnt see any good visuals so not sure what to so
doctor
Answered by Dr. Vivek Chail (17 minutes later)
Brief Answer:
You must take a test dose and be premedicated before the scan

Detailed Answer:
Hi,
Thanks for writing back with an update.

In your case guidelines have to be followed when doing the investigation.

I hope your doctors have discussed the requirement of the MRI angiography and are proceeding with it after knowing that you have hdad reactions to the contrast XXXXXXX earlier and this investigation is justified.

You must be premedicated with anti allergy drugs and an anesthetist must be on alert when your scan is going on. Even during the scan, you must communicate with the technologist if you develop and kind of discomfort.

The team doing your scan must give you a small test dose before the actual injection is given. Any adverse reaction should be reported and the scan can be abandoned.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (7 minutes later)
I am sorry it is not an angiogram mri it is an arthogram so they can see the labrum inject XXXXXXX into the joint And the labrum. Should have have the dr request an anesiologist to intibate me and keep me stable and monitor the pain and swelling? Because from everything i read they cant arthrogram without the injection. I tried before taking bendryl and a dose of steriods but didnt work. Sorry just concerned.
doctor
Answered by Dr. Vivek Chail (13 minutes later)
Brief Answer:
Contrast reaction during MR arthrography is rare and care needs to be taken

Detailed Answer:
Hi,
Thanks for writing back with an update.

Arthrogram is a special investigation and the contrast is directly injected in to the joint. Due to this direct injkection, the chance of a reaction is low. Reaction rate is higher in contrast angiography where injection is given in the vein.

Therefore, MRI arthrogram is safer than MRI angiography from contrast injection point of view.

However it is important to keep in mind the points discussed earlier and you might choose to get intubated and monitored closely if recommended by your doctors. This is more important if the earlier XXXXXXX reaction was dueing MRI arthrography.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (11 minutes later)
My reaction was actually to done to an arthrogram notnan angiogram. I know it is rate but seem to get the rare things happening to me. So any further advice as this is my final follow up? Would you comsider being intibated and monitored? Or any other suggestions
doctor
Answered by Dr. Vivek Chail (1 hour later)
Brief Answer:
Monitoruing is recommended and intubation team can be on alert

Detailed Answer:
Hi,
Thanks for your update.

Since you had reaction to arthrogram therefore you are highly sensitive to the XXXXXXX In my opinion you can have the anaesthsia team on standby with you at the time of giving the injection. Once you are confirmed stable then they can proceed with the scan. Monitoring can be done continuously but intubation is not required.

Hope your query is answered.
Please do write back if you have nay doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Vivek Chail

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Practicing since :2002

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Suggest treatment for swollen and painful shoulder

Brief Answer: There are MRI angiography techniques which do not require XXXXXXX injection Detailed Answer: Hi, Thanks for writing in. Contrast reactions are very rare and unfortunately you have had it in earlier. You must not take any similar XXXXXXX injection as it can adversely affect your health. However MRI angiography techniques are available which do not require the use of a contrast XXXXXXX Therefore I suggest you discuss with your doctor and the radiologist and technologist request if they can do MRI angiography using a technique which does not require XXXXXXX injection. Hope your query is answered. Please do write back if you have any doubts. Regards,