radiology report terminology? Doc.Sust?

[4on1off]

i talked the nurse into giving me a copy of the MRI results for my shoulder although the doctor wont be back in town till monday to explain what was found. anybody understand this terminology?

MRI REPORT
FINDINGS: Moderate fluid is present in the subacromial-subdeltoid bursa. The supraspinatus tendon is grossly intact but has increased signal distally. Marked hypertrophy of the acromioclavicular joint is noted. This appears to cause impingement. i see no definite labral tear.
IMPRESSION:
(1) Increased signal in the supraspinatus tendon and fluid in the subacromial- subdeltoid bursa. This likely represents tendonosis and bursitis.
(2) Hypertrophy of the acromioclavicular joint, which appears to cause
impingement. Clinical correlation is recommended.



can anybody make heads or tails of this?

[MuscleScience]

Yeah its pretty strait forward, You have anterior impingment syndrome and they are going to have to shave the end of your acromion process which is the end part of your shoulder blade. They do this to make room because you have an increase in the size more than likely of the supraspinatus muscle. This decreases the compartment room causing your acromion process to rub against the tendons of your rotator cuff causing pain, imflamation and sometimes rotator tears. Since your Supraspinatus is "Grossly intact" that implies that there are no seroius tears or even a flattening of the tendon which decrease the muscles functional range of motion. The Labrum is the ligament that holds the ball of your humerus (upper arm bone) into place.

hope this helps

[Timm1704]

you will likely need surgery on the AC joint. I had it 3 years ago, along with afew others off here, and its not so bad, recovery time is quick, although i think your case may be slightly more harsh than mine, as mine didnt show up on the MRI

[MuscleScience]

Yeah Timm is right, its a pretty simple and relatively quick recovery if thats all they find when they go in.

Best of Luck to ya.

MS

[Doc.Sust]

clinical corelation means you pretty much need surgery for impingement syndrome

[4on1off]

when/if they go in how do you think they do it? do you think they will lay it open or go in with scopes? inpatient, outpatient? how many weeks do you think i am looking at for recovery? i was told 6 to 8 weeks for a repaired rotator cuff, am i still looking at 6 to 8? i have been around for 40 years and have never had surgery before, this is new ground for me.

[MuscleScience]

They will use and endoscope and you will be in a sling for a good 4-6 weeks at least.

[Timm1704]

for my surgery i was in hospital one night only, left the place right after breakfast (which was dry, bastards). I was driving within 10 days, and only wore my sling if i felt necessary after a week or so. I have one small scar above my clavicle, and two others (one side delt, one rear delt) which are barely visible. Within two months I was back in the gym, could likely have been in sooner mind you, as I was already able to swim again before that.

Hope fully this will give you some idea of the time frame for recovery, keep in mind I was 18 years old (19 the following month) so the recover was likely quicker than someone older

[Doc.Sust]

scopes, quick and easy

[4on1off]

thanks for the information.
knowing what to expect seems to help.
i am looking forward to getting this over with and getting back in the gym.

[MuscleScience]

Yeah you will be back bench 500 lbs in no time at all.

[4on1off]

well...heh....i dont know about that.....im new to the iron game, i was working on the 300 club when this injury brought things to a pause. 500 is a loooooonnnnnng way off.

[Doc.Sust]

best of luck

[4on1off]

thanks,

good news today (kind of). just got home from a long trip to see the specialist.
no tears in the tendons, he said my shoulder looked healthy (no slack felt after pulling, twisting, lifting, cranking and just plain trying to make me cry) and gave me a 7 cc shot of steroid DEEP in the shoulder with what looked like a 12 inch pin. ouch...., i dont know what was worse, the moving of the shoulder or the shot in the shoulder joint. wife made fun of me as she watched. 4 weeks of physical therapy and a trip back to the doc for a check. if not enough progress then he will go in and start whacking bone.


for those of you interested in the details of the injury and treatment for whatever reason here are the details..........


pain: before the injury i would have pain if i slept on the "bad" shoulder.
dull pain inside(top middle)of shoulder when resting weight of body on
that elbow for extended time(driving/watching tv), sharp pain when flat
bench or incline with heavy weight, medium pain when performing
front/side stiff arm shoulder raises with weight. then came the injury.


pain history: first signs of pain a year ago when leaning on elbow or sleeping
on shoulder, lasting anywhere from a few min. to all day.
6 months ago started lifting and noticed slight pain on incline
press then later on bench (increased warm time up and started
glucosamine sups that only slowed progression of pain till injury
on 4-12-07). some days i could make it through a workout with
not much pain then sometimes the pain would not let me start
the first working set.


birthday: day of injury was a very low pain day. i had moved up in weight
and cranked out two sets of eight but was expecting only 5
reps on the first set and less than that on the second so you can
imagine how jacked i felt at that moment. started the third set
feeling like another 8 reps maybe even nine without help
and as soon as i unlocked the weight and started down the
shoulder popped. i felt a very sharp pain in my shoulder,
the weight came down so fast i couldn't twist the bar to lock
it back in, shoulder popping all the way down-loads of pain.
(after the second set i thought to myself "this is a great b-day
present!" then a min. later after i drug myself out from under the
bar holding my shoulder, i thought "this is one hell of a messed up
present-WTF!!!")

time line : 4-11-07 preform arm movements/stretch
before warm up sets. able to move arm
(no weight) freely with no pain.
4-12-07 injury, loads of pain, cant sleep
4-13-07 trip to family doc & x-ray
noticed a virtical whelp on back of
shoulder @ injury/shoulder socket area.
4-16-07 MRI (noticed pain subsiding but cannot
move arm much without causing loads of
pain) still hard to sleep more than 2 hours
at a time.
4-20-07 less arm resting pain, alittle more movement
more sleep.
4-24-07 able to raise arm very carefully with help
but only in certain position w/ mild pain
4-26-07 trip to specialist for evaluation and shot,
have noticed that pain with arm in sling or
resting gets less with each passing day but
still cannot raise arm above shoulder without
help. getting aprox 6 hours sleep now. doc
gave scrip for sleep aid, start lunesta
tomorrow. start therapy monday.


ill post more details as they happen.....

[4on1off]

spent last week doing rehab for the shoulder.

monday, wednesday, and friday spent time at the clinic getting heat treatments, doing exercises and specific movements targeting the shoulder.

tuesday and thursday spent time at home 3x a day doing the movements and exercises i learned at the clinic.

the heat treatments (ultra sound and hot pack) seemed to work the most on reducing the pain but the exercises brought the pain right back.

as the week progressed, the pain continued to grow from the exercises. friday after talking about the increased pain level and the sounds/ feelings coming from inside the shoulder the therapist decided to stop all exercises , gave me a 10 min ultra sound joint heating, a 10 min. hot pack and a 20 min. electro shock treatment, then sent me home to rest till monday.

after the first day at rehab i felt pretty good and thought i would get through this without getting cut on, but now after a week of trying to work the shoulder and getting nowhere and even getting worse, my feelings have changed.

one week in on a four week ride and the therapist has brought everything to a grinding halt........hmmm........

[4on1off]

im half way through week three.

last two weeks of rehab have been up and down. it seems that the heat and shock treatments are working better than just the heat treatments.

we also slowed down on the exercises. i dont do exercises at home anymore only what is done at the rehab clinic three times a week.

4 more trips to rehab then its off to see the doctor for a decision about surgery.

[Doc.Sust]

i dont think they should be using heat, heat blows! ice i the ticket

[4on1off]

doc.
i am confused by your last post.
help me out here......

i have tendonosis.

as per your sticky of david ryan D.C.'s information on tendonosis/tendonitis:

*tendonosis*
1 very common

2 requires months/years to heal

3 treated with rehab exercise

4 irritated my NSAID's

5 shows up black on MRI

6 Degenerative

7 feels better with movement

8 soothed by heat

9 worse with ice and rest

10 helped with massage

11 surgery offers no help

12 cool to touch



your sticky says heat but your last post says ice.
the heat seems to help more that not using heat. when i exercise without the heat treatments i suffer more pain and have more lingering pain afterwards. although i have yet to try ice, i feel like it would increase the pain even more. what am i to do?

[Doc.Sust]

doc.
i am confused by your last post.
help me out here......

i have tendonosis.

as per your sticky of david ryan D.C.'s information on tendonosis/tendonitis:

*tendonosis*
1 very common

2 requires months/years to heal

3 treated with rehab exercise

4 irritated my NSAID's

5 shows up black on MRI

6 Degenerative

7 feels better with movement

8 soothed by heat

9 worse with ice and rest

10 helped with massage

11 surgery offers no help

12 cool to touch



your sticky says heat but your last post says ice.
the heat seems to help more that not using heat. when i exercise without the heat treatments i suffer more pain and have more lingering pain afterwards. although i have yet to try ice, i feel like it would increase the pain even more. what am i to do?

opps i was confused, i thought u had tendonitis, disreguard my last statement

[4on1off]

i finished my rehab and pretty much reached a plateau. i have full movement of my shoulder but can't lift much weight or make quick movements. i can get through the day with no pain if i take my meds and dont try to use my shoulder for lifting heavy stuff over my head or try to throw anything.

i went to see the surgeon for a follow up and he said it was my decision on whether to tough it out or get cut. he said it would take three months for recovery before i could go back to work after surgery. i told him to give it another month then we will talk about it again. he released me to go back to work full duty.

i worked wednesday, thursday and friday and managed to do something to hurt my shoulder every day. i really have to be careful. i didnt realize how much i use it when im at work.

i feel like ill be better off if i get the surgery. if i had not reached a plateau in rehab i may feel alittle different about it.

my short term disability will reset april of 08, i figure ill tough it out till then....