Shoulder Injury - MRI Images


Hi Guys - need some help/input
45 no history of shoulder pain or injury, nothing. Last month on elliptical after a light work out and something in my shoulder snapped/popped, felt like someone stabbed me! Lose of mobility, sharp shooting pains with certain movements, and now shoulder clicks and hangs up. @!$@#&?!!
Had an MRI with contrast last week, pics attached, think my doc is a quack, he wants to perform a complete shoulder replacement, WTF!
If anyone can read these images or has any input please chime in! I have an apt for a 2nd opinion in two weeks and the wait is killing me!

Do you have the radiologists report?

Im by no means trained, though I have seen a few MRIs in my time, and I dont see any particularly blatant derangement but theres a lot of other slices I cant see so my opinion is basically worthless here.

Def go for the second opinion.

I’ve requested a copy of the report.
Doc, said I have “severe arthritis, the shoulder of a 70yr old.”
Agreed on 2nd opinion, thanks

Did you do any rehab? I know lots of 70 year olds and none of them have surgically replaced shoulders.

No rehab yet. Doc went straight to complete shoulder replacement.

[quote]Wishihad wrote:
No rehab yet. Doc went straight to complete shoulder replacement. [/quote]

That’s pretty bizarre that there was zero in-between.

I have nothing to offer except I think it would be really cool to have cybernetic shoulders. At least in concept.

Bizarre agreed!
Had MRI at 4pm on Tuesday done at 4:45p. Doc office called at 10a Wednesday, the next day, asking me to come in at noon and recommended a total shoulder! When did the radiologist read my MRI, when did the doc review? Why don’t my symptoms match what his diagnosis ? Why so fast!!!

I would run far and fast. Unless you have a systemic disease and the joint needs to be removed immediately, I can’t see any reason for replacement surgery without a trial of conservative care first. When you get your second opinion ask if this doctor is acting ethically, because it looks a lot like he’s trying to fill his schedule.

So I got a copy of the MRI report today and it doesn’t match with what my surgeon/doc told me. He told me I had severe arthritis, the shoulder of a 70 year old and no labral tears. I specifically asked about a labral tear, as my symptoms perfectly match a labral tear.
The report says - “mild to moderate gluenohumeral joint osteoarthritis… degenerative labral tearing is seen”

I have a bone spur so big in my right shoulder it pokes out on the skin and I’m nowhere near a shoulder replacement. Unless there are other variables you haven’t told us, yeah run away from that quack.

On second thought you do have a lot going on. Are you willing to try PT first?

I will try anything and prob everything before I let them (anyone) cut out my shoulder!!!
My 2nd opinion is next Tuesday. Regardless of the outcome I will not be going back to doc #1.
Reading/researching: PT, HGH, Platelet and stem cell therapy options.
Anyone have any experience with any of these?
Thanks

A manual therapist should probably be your first option. Correcting the biomechanics of the shoulder is going to be necessary to halt the progression of degenerative processes. The labrum may or may not respond to manual therapy but labrum repair surgery is MUCH less invasive than total replacement. Stay optimistic and go to ALL your therapy (even if you’re not in pain) and you should be back in the saddle ASAP.

[quote]CroatianRage wrote:
A manual therapist should probably be your first option. Correcting the biomechanics of the shoulder is going to be necessary to halt the progression of degenerative processes. The labrum may or may not respond to manual therapy but labrum repair surgery is MUCH less invasive than total replacement. Stay optimistic and go to ALL your therapy (even if you’re not in pain) and you should be back in the saddle ASAP.[/quote]

I’ve been having great success with this, dealing with my own subset of shoulder issues. I found a team that does chiropractic work, massage work and rehab work, and I’ve had great results just after the first couple weeks. They work with a number of professional athletes.

I started with the local pro football team and their list of team chiropractors over the years and went from there.

I had a massive Rotator cuff repair about a year ago. Do not trust MRIs. The issue for me was that the initial MRI showed nothing. Then I had a re-injury, it showed a possibly torn supraspinatus. I decided on surgery and it turns out that 3 of 4 RC muscles were torn off completely as was the long head of the biceps. 5 hours of surgery rather than the 45 minutes they thought. I also had an MRI that showed I needed to have my neck fused but I got a second opinion and the issue was postural. A month later I was pain free.

A complete replacement is a huge step. I remember one young women some years back who was having hip pain and went to a doctor who basically talked her into a double hip replacement mostly because he wanted the practice. She was in her early 20’s and the prognosis was a couple of revisions then a wheelchair sometime in her 40’s. Just saying that doctors don’t always have pure motives either. She was investigating malpractice and I hope she won.

My point is that MRIs are hard to read right and getting surgery based on them for me has been a very mixed bag. Find a doctor who specializes in high-end athletes (PM me if you can get near Chicago and I’ll tell you who I used). Most orthos who do not do Sports Med. think athletes should cease and desist all activities, which ain’t gonna happen. Most Sprts Med. doctors want to get you back to training ASAP and try hard to make it happen.

– jj

[quote]jj-dude wrote:
My point is that MRIs are hard to read right and getting surgery based on them for me has been a very mixed bag. Find a doctor who specializes in high-end athletes (PM me if you can get near Chicago and I’ll tell you who I used). Most orthos who do not do Sports Med. think athletes should cease and desist all activities, which ain’t gonna happen. Most Sprts Med. doctors want to get you back to training ASAP and try hard to make it happen.
– jj[/quote]

Second this, and I think anybody with a significant shoulder injury should heed this advice.

I had shoulder surgery when I was 15 for a torn rotator cuff. Surgery was warranted but the doctor did a debridement when he probably should have done a repair. I don’t necessarily fault him for taking a conservative approach, but I do have issue with two doctors that I saw later in my teens and early twenties.

First doctor saw nothing on an MRI and basically told me to toughen up. He only looked at one shoulder as I told him it was worse, but that the other shoulder also bothered be a lot and had completely different symptoms.

Second doctor again saw nothing on an MRI (arthrogram even this time). He told me he could do exploratory surgery if I really felt something was wrong. I knew something was wrong but really wasn’t comfortable with a doctor that couldn’t even give me a preliminary diagnosis.

Finally saw another doctor this year. He is the head physician of one of the pro sports teams in my area. He just about nailed the diagnosis before even doing the MRI’s (both shoulders this time). I will add at this point that the radiologist reviewed my MRI’s immediately afterwards, so that part of your post wasn’t surprising. The doctor agreed with the radiologists report, and I’ve since had both operated on. After surgery, the only part of my diagnosis that was incorrect was that we thought I had two tears in my right labrum but there was only one. I have some wrinkling in the superior portion of my labrum that caused the dye to leak out and resembled a tear on the MRI. Turned out I only had a posterior tear on that side. You can read my post at the bottom of the first page in the injuries forum for more info.

Point is, there is really no replacement for an experienced, qualified physician. Get a second opinion and if you’re not satisfied go for a third.

Thanks for all the input! Getting 2nd opinion tomorrow, hoping I don’t have to go for a third! Will update post visit.

I’ve got a labrum tear and it happened 10 years ago, when I was 24. The hgh that ive taken has helped a lot, and it almost seems 100%

[quote]lumbernac wrote:
I’ve got a labrum tear and it happened 10 years ago, when I was 24. The hgh that ive taken has helped a lot, and it almost seems 100%[/quote]

Can you elaborate on your HGH use with respect to your shoulder… time, length, dose?
Thanks

I’m experiencing a frequent feeling like something is physically catching or binding accompanied with a sharp stabbing pain. So I’m assuming some surgery is going to be needed to fix the mechanics. But, I’m very interested in anything I can do to accelerate or help healing!!

[quote]Wishihad wrote:
Thanks for all the input! Getting 2nd opinion tomorrow, hoping I don’t have to go for a third! Will update post visit. [/quote]

How did it go?