ZocdocAnswersWhat does my MRI report really say?

Question

What does my MRI report really say?

I have been having shoulder pain, stiffness, crackling, and the feeling of my shoulder popping out of place ad then back in ever since a fall (FOOSH) six years ago. I am a photographer, backpacking and fishermen and increasingly am having a more and more difficult time doing these tasks. I had an MRI with contrast and got the report back. Here's what it says: There is moderate hypertrophic changes of the acromioclavicular joint with subacromial spurring contributing to moderate narrowing of the underlying subacromial space. There is tendinosis and undersurface irregularity of the supraspinatus tendon. There is tendidosis and undersurface tearing of the infraspinatus tendon. There is no evidence of a full thickness tear. I have, in the past, had cortisone injections and gone through months of PT with little improvement. My question is, what does the MRI report say and is surgery an option at this point?

Answer

I am very sorry to hear that you are having such persistent trouble with shoulder pain and limited mobility. Given the fact that you have had several cortisone injections and also have had a long course of physical therapy with little improvement, an MRI was definitely an appropriate test to order at this point. There are several important findings on the MRI. One of this is that you have some arthritis of the acromioclavicular joint, which is the joint that joins the clavicle to the shoulder blade. This arthritis could definitely be the source of some of your symptoms. Furthermore, you have evidence of damage to the rotator cuff, which are the tendons which surround the shoulder joint and support movement of the arm and shoulder. In particular, there is some tearing of one of those tendons (the infraspinatus), although, fortunately, it is not a complete tear. What you probably need to do at this point is make an appointment with an orthopedic surgeon to review the findings of the MRI and get some advice from them on what they think needs to be done now. There are several surgical approaches which might be reasonable at this point, including an arthroscopic surgery, but the surgeon will be able to analyze your case and give you specific pointers on the risks and benefits of those approaches.

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