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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Supraspinatus Tendonitis With An Intraosseous Ganglion Cyst

HI MY NAME IS MARGIE AND I WOULD LIKE TO NOW HOW BAD THIS IS . THERE SUPRASPINATUS TENDINOSIS , WITH A CHRONIC HIGH-GRADE PARTIAL INTERSTITIAL TEAR AT THE ANTERIOR INSERTION, FILLED WITH INTERMEDIATE SIGNAL MATERIAL COMPARTIBLE WITH SCAR, MEASUNING APPROXIMATELY 1 CM IN DIAMETER. THERE IS A ROUNDED NONAGGRESSIVE LESION IN THE ANTERIOR FACET OF THE GREATER TUBEROSITY OF THE HUMERUS , WITH A T1 HYPOINTENSE/T2 HYPERINTENSE PORTION SURROUNDED BY A RIM OF ENHANCING MORE T2 HYPERRINTENSE MATERIAL, MOST COMPATIBLE WITH AN INTRAOSSEOUS GANGLION CYST WITH SURROUNDING ENHANCING INVAGINATING SYNOVIUM. THE LESION MEASURES 1.3 X 1.2 X 1.4 CM THERE IS NO SURROUNDING MARROW EDEMA , OR SOFT TISSUE MASS. THERE IS A MODERATE INFRASPINATUS TENDINOSIS WITHOUT A FOCAL TEAR. THRE IS A SMALL CHRONIC HIGH-GRADE PARTIAL THICKNESS BURST SURFACE TEAR OF THE SUBSCAPULARIS TENDON NEAR THE LESSER TUBEROSITY INSERTION, MEASURING 9 MM LONG 6 MM WIDE . NORMAL TERES MINOR TENDON.NORMAL SUPRAS MUSCLE. NORMAL INFRASPINATUS MUSCLE. NORMAL SUBSCAPULARIS MUSCLE. NORMAL TERES MINOR MUSCLE.THERE IS IRREGULARITY AND ELEVATED SIGNAL WITHIN THE SUPERIOR LABRUM SPANNING THE 10 TO 12 POSITIONS, COMPATIBLE WITH DEGENERATION AND A PROBABLE TEAR, ALTHOUGH EVALUATION WAS MOTION-LIMITED. THERE IS NO EFFUSION . THERE IS NO HILL SACHS LESION.THERE IS MODERATE TENDINOSIS OF THE INTRA-ARTICULAR PORTION OF THE LONG BICEPS TENDON. THERE IS THICKENING OF THE CORACOHUMERAL LIGAMENT, WITH LOW SIGNAL MATERIAL EFFACING THE SUBCORACOID FAT TRIANGLE COMPATIBLE WITH ADHESIVE CAPSULITIS IN THE ROTATOR CUFF INTERVAL.THERE IS A MILD ACROMIOCLVICULAR JOINT ARTHROSIS. THERE IS A CURVED ACROMION WITH A LATERRALLY DOWNSLOPING ORIENTATION AND A NEAUTRAL POSITION.THERE IS A SMALL AMOUNT OF SUBACROMIAL SUBDELTOID BURSAL FLUID.NORMAL DELTOID MUSCLE. NORMAL TRAPEZIUS MUSCLE.NORMAL QUADRILATERAL SPACE . NORMAL AXILLARY SPACE.POSTCONTRAST IMAGES DEMONSTRATE ENHANCEMENT OF THE T2 HYPERINTENSE PORTION OF THE HUMERAL GREATER TUBEROSITY LESION COMPATIBLE WITH FIBROUS TISSUE.IMPRESSION- MRI OF THE RIGTH SHOULDER DEMONSTRATES:1. CRONIC HIGH-GRAE PARTIAL THICKNESS INTERSTITIAL TEAR OF THE SUPRASPINATUS TENDON AT THE ANTERIOR INSERTION FILLED WITH INTERMEDIATE SIGNAL MATERIAL, COMPATIBLE WITH SCAR OR TENDINOSIS. MODERATE INFRASPINATUS TENDINOSIS.2. CHRONIC HIGH-GRADE PARTIAL THICKNESS BURSAL SURFACE TEAR OF THE SUBSCAPULARIS TENDON NEAR THE LESSER TUBERSITY INSERTION.3. 1.4 CM NONAGGRESSIVE ROUNDED LESION WITHIN THE ANTERIOR FACET OF THE GREATER TUBEROSITY OF THE HUMERUS, MOST COMPATIBLE AN INTRAOSSEOUS GANLION CYST.4 LIKELY DEGENERATIVE TEAR OF THE SUPERIOR LABRUM FROM THE 10 TO 12:00 POSITIONS. LIKELY CHRONIC TEAR OF THE ANTERIOR-INFERIOR LABRUM. FURTHER EVALUATION COULD BE PERFORMED WITH DIRECT MR ANTHROGRAPHY IF CLINCALLY INDICATED.5. MODERATE INTRA-ARTICUKAR LONG BICEPS TENDINOSIS.6. ADHESIVE CAPSULITIS WITHIN THE ROTATOR CUFF INTERVAL.7.MILD ACROMIOCLAVICULAR JOINT ARTHROSIS . LATERALLY DOWNSLOPING ACROMION.8. MILD SUBACROMIAL SUBDELTOID BURSITIS.
Fri, 4 Nov 2016
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Orthopaedic Surgeon 's  Response
Hi
Your supraspinatus tendonitis and abnormal intraosseous cyst need surgical management..the deposits at. Joint kevel and humerus upper end need evacuation to promote healing of this tendon.
Consult a shoulder surgeon for this
Thanks
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Suggest Treatment For Supraspinatus Tendonitis With An Intraosseous Ganglion Cyst

Hi Your supraspinatus tendonitis and abnormal intraosseous cyst need surgical management..the deposits at. Joint kevel and humerus upper end need evacuation to promote healing of this tendon. Consult a shoulder surgeon for this Thanks