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What do my test reports indicate?

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Posted on Wed, 20 May 2015
Question: Do I need to change my Ortho Dr? Or Seek out a Back/Neck surgeon?
Can EMG cause issues? Why would I need another if the 1st one found nothing?
How long can the finger numbness exists before it is permanent damage?
Help! It has been a year with minimal shoulder relief, but additional issues even worse!
====Summary==04/2014===04/2015
Patient complaint:
1) Shoulder pain,
2) loss of shoulder movement,
3) arm pain steadily increasing;
4) neck pain;
5) hand pain steadily increasing,
6) knuckles swollen,
7) loss of grip,
8) tingling in fingers AFTER EMG,
9) loss of feeling in fingertips AFTER EMG;
10) Fibromyalgia flared up;
Exams: from 1) Primary Care *2,
2) Orthopedic *4,
3) Back Pain Specialist *5,
4) Rheumatologist *2
Tests: Shoulder Xrays; MRI shoulders and neck; EMG; Hands Xrays; Blood Work; additional EMG ordered;
Rx: Celebrex; 2 Steroid shots in shoulders *3; Oral Steroids; Lyrica; Hand braces;
PT: 4 weeks *3, plus 6 weeks *1;
Dx: 1) Shoulder tendonitis due to "repetitive stress or overuse... minor injury of that tendon";
2) Shoulder Impingement Syndrome / Subacromial Bursitis in both shoulders;
3) Impression: 0.2 cm posterior disc protrusions are seen at C4-5 and C6-7 disc protrusion cause some narrowing of the right lateral recess.;
4) Potential Psoriatic Arthritis;
5) existing Fibromyalgia;
Duration: 1 year!!!
doctor
Answered by Dr. Shruti Rijhwani (1 hour later)
Brief Answer:
Diagnosis needs further work up.

Detailed Answer:
Dear Madam,

Thank you for posting your query on HCM.

Well looking into your problem I would like to tell you that back or neck surgeon wont do much because your MRI shows minimal compression so there seems no point in operating.

Secondly yours seems to be a chronic disease so expecting much improvement after 1 year looks little difficult for me even with best interventions .As due to continuous inflammation going on some damage has already taken place and it becomes worse with further growing time rather than reversal .

Other issue you said psoriatic arthritis is a potential diagnosis but you are not taking any treatment for the same . May be starting with Methotrexate will help you if this is the case . Your numbness of fingers can be due to carpal tunnel syndrome that can be secondary to arthritis and swelling in the wrist .

Rest any other query we will be happy to answer. If you think there is some other relevant report or history then let me know so that we can understand your issue better and help you out .

Take care.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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What do my test reports indicate?

Brief Answer: Diagnosis needs further work up. Detailed Answer: Dear Madam, Thank you for posting your query on HCM. Well looking into your problem I would like to tell you that back or neck surgeon wont do much because your MRI shows minimal compression so there seems no point in operating. Secondly yours seems to be a chronic disease so expecting much improvement after 1 year looks little difficult for me even with best interventions .As due to continuous inflammation going on some damage has already taken place and it becomes worse with further growing time rather than reversal . Other issue you said psoriatic arthritis is a potential diagnosis but you are not taking any treatment for the same . May be starting with Methotrexate will help you if this is the case . Your numbness of fingers can be due to carpal tunnel syndrome that can be secondary to arthritis and swelling in the wrist . Rest any other query we will be happy to answer. If you think there is some other relevant report or history then let me know so that we can understand your issue better and help you out . Take care. Dr. Shruti