Can someone please explain this MRI report to me?

[Tommy Gunn]

Can someone please explain this MRI report to me? My doctor went over it with me but I just want to hear what you fellas think:

FINDINGS: There has been interval development of interstitial tear with tendon delamination of the posterior fibers of the distal supraspinatus tendon and the anterior fibers of the distal infraspinatus tendon extending from the musculotendinous junction to their insertion on the greater tuberosity. The interstitial tears are superimposed on changes of supraspinatus and infraspinatus tendinosis. There is no full thickness supraspinatus or infraspinatus tendon tear at this time and no clearcut extension of the interstitial tear to the bursal surface or infraspinatus tendon tear at this time and no clear cut extension of the interstitial tear to the bursal surface or to the articular surface at this time.

IMPRESSION: Interval development of interstitial tear with tendon delamination involving the posterior fibers of the distal supraspinatus tendon and the anterior fibers of the distal infraspinatus tendon extending from the musculotendinous junction to their insertion on the greater tuberosity. There is no full thickness rotator cuff tear and no clearcut extension of the interstitial tear to the articular surface or the bursal surface at this time.

[MuscleScience]

It means you have some fraying of the tendons. Distal means its towards the insertion point of the muscle on the greater tuberosity of the humerus.

[Tommy Gunn]

It says "There has been interval development of interstitial tear with tendon delamination..."

What does 'interval development' mean?

What does 'tendon delamination' mean?

It also says "The interstitial tears are superimposed on changes of supraspinatus and infraspinatus tendinosis."

What does 'superimposed' mean?

[MuscleScience]

1. interval, means that it has discontinuous damage along the tendon

2. delamination means for the tissues to seperate from the surounding structures.

3. The SS and IF tendons come together to form the rotator cuff proper. I am only guessing on the superimposed part that its at a union of the two tendons.

[2bshredded]

Have you taken them to the Ortho yet....hopefully you have an appointment...I was in the same situation, but, after the appt/ with the Surgeon all my questions were answered and 3 weeks later good as old!
It's all different, hopefully yours be go as well as mine did.....good luck, talk to the Doc.
Or maybe hit up Dr. Sust., he maybe can answer your questions.

[Tommy Gunn]

1. interval, means that it has discontinuous damage along the tendon

2. delamination means for the tissues to seperate from the surounding structures.

Bro, you are obviously a lot smarter than I am. Not to be a pain but I don't understand what you mean on these 2. Can you explain both to me like I'm a 2 year old? I have no idea what 'discontinuous damage along the tendon' means. I think I understand tendon delamination but can you explain it in more detail to me (The 'superimposed' thing I understood but I'm having a hard time understanding these 2).

[MuscleScience]

Basically its like when you laminate something together you layer it and compress it to form a stronger structure. To delaminate means for the underlying tissue that would normally be part of one functional unit. It is damaged from repeated stresses and seperates out causing inflammation and weakining of the overall unit. In this case the tendons of the rotator cuff.

[MuscleScience]

this might help.

http://forums.steroid.com/showthread.php?t=221463

[Tommy Gunn]

Basically its like when you laminate something together you layer it and compress it to form a stronger structure. To delaminate means for the underlying tissue that would normally be part of one function unit. It is damaged from repeated stresses and seperates out causing inflammation and weakining of the overall unit. In this case the tendons of the rotator cuff.

Thanks for clarifying 'tendon delamination' for me. 2 things:

1. Can you explain the 'discontinuous damage along the tendon' thing?

2. In your opinion, based on this MRI report, should this be causing my shoulder to be in extreme pain when I do these motions and strength tests?:

http://www.maitrise-orthop.com/corpu...oileau/29d.jpg

http://www.aafp.org/afp/20000515/3079_f4.jpg

It also KILLS if I do these motions (with NO weight):

http://www.exrx.net/WeightExercises/...lRotation.html

http://www.exrx.net/WeightExercises/...ntOverRow.html

If any of you other fellas have an opinion on this, I could definitely use your help.

[MuscleScience]

1. that just means that the tear or damage kinda skips along the tendon. Some parts are ok some are damaged.

2. the first picture test the strength of the supraspinatious muscle (SP). If it is weak or injured one side will be easier to push down. The SP muscle is involved in raising your arm. You may also have tight trap muscles on that side of your body because your traps compensate for the lack of strength or pain in the shoulder when raising it up.


the second picture is for test external rotation of the arm. This test the infraspinatous (IS) same thing applies if it is damaged or weak it will be easy for the examiner to move it and may cause pain in the orthopedic test.

The third picture is a combination of abduction (SP muscle) with external rotation (IF muscle)

The last picture is basically retraction of the scapula (shoulder blade) this is the origin of both the muscles your having problems with. You may have some anterior impingment which can cause pain. Which is nothing more than the irritated muscle rubbing against the bony process (Acromian Process) of the shoulder blade due to inflammation.

[MuscleScience]

I had almost the same exact injury as you do from baseball, but I had damage to my bicep tendon and not my SP muscle. It hurt like hell btw.

[Tommy Gunn]

MuscleScience, let me ask you something:

I used to be into amateur boxing. When I throw punches right now I can pretty much throw them with some pain but not excruciating. HOWEVER, there is one punch that puts me in EXCRUCIATING LEVEL 10 PAIN...and that is when I throw an uppercut.

Can you explain why when I throw an uppercut I'm put in EXCRUCIATING LEVEL 10 PAIN but when I throw other punches it doesn't hurt as bad? Is that consistant with the MRI findings? Don't get me wrong when I throw other punches it hurts like hell but NOTHING compared to when I throw an uppercut.

[MuscleScience]

Yes to all of them.

[MuscleScience]

Those ortho test specifically isolate the muscles in question. A positive test for pain, restriction or weakness along with a abnormal MRI would lead to the diagnosis your doc went over with you.

I am not an MD so any and all advice and or information should be taken with a grain of salt.

But I did stay at a holiday inn express last night. LOL

[Tommy Gunn]

MuscleScience, what about this question I posted:

MuscleScience, let me ask you something:

I used to be into amateur boxing. When I throw punches right now I can pretty much throw them with some pain but not excruciating. HOWEVER, there is one punch that puts me in EXCRUCIATING LEVEL 10 PAIN...and that is when I throw an uppercut.

Can you explain why when I throw an uppercut I'm put in EXCRUCIATING LEVEL 10 PAIN but when I throw other punches it doesn't hurt as bad? Is that consistant with the MRI findings? Don't get me wrong when I throw other punches it hurts like hell but NOTHING compared to when I throw an uppercut.

[MuscleScience]

Yeah its actually pretty simple to explain. Your SP muscle is used for shoulder flexion, your IS muscle is used as a de-accelerator. You hurt because both muscles tendons are injured and when they sense a rapid movement such as a punch they fire your pain receptors.

Basically when you throw an upper cut your SP muscle is used to help to throw the punch. Your IS muscle is used to check the motion of the arm to keep the shoulder joint in its normal range of motion.

[Tommy Gunn]

Anyone else wanna interpret this MRI report for me?

[MuscleScience]

Anyone wanna interpret this MRI report for me?

Get ahold of Doc Sust, he would be able to explain it better than I could. I have a general gist of whats going on from all my anatomy and sports med stuff I have done through my academic career, he would have a pretty good idea of exactly what it happening with you.

I know this has been going on for a while with you I know we have talked before about your shoulder. Good luck with your healing and just a little word of advice coming from someone that has had several severe shoulder injuries. Try not to get to frustrated with it and take your time when trying to recover.

[Tommy Gunn]

Thanks for the advice MuscleScience, hopefully Doc Sust checks this thread out.

[MuscleScience]

I will shoot him a PM for your.