Hello doctor,
During a ski trip a few months ago, I fell on my outstretched hand during a jump and injured my shoulder. I did a magnetic resonance imaging (MRI) scan immediately after, and the radiologist said that it was not going to be a big deal. However, my shoulder is still bothering me quite a lot, so I thought it would be good to get a second opinion. I also got a computed tomography (CT) scan done yesterday. I do not have a medical history concerning my upper body.
Please help me.
Thank you.
Hi,
Welcome to icliniq.com.
I can understand your concern.
I have carefully gone through all your magnetic resonance imaging (MRI) and computed tomography (CT) images (attachment removed to protect the patient's identity). Unfortunately, I find that there is some injury to the shoulder joint.
I do not see any fracture in the computed tomography (CT) scan. However, a magnetic resonance imaging (MRI) scan shows a bony contusion or a bone bruise at the greater tubercle of the humerus (the outer surface of the shoulder). Bone contusions can last for quite long after an injury and can bother a person. I think this may require some medication and therapy (physiotherapy and hot or cold compression).
The other finding on the magnetic resonance imaging (MRI) scan is fluid collection in the rotator interval, signifying rotator interval tear. This is a combination of ligaments that bind the arm to the shoulder. So this tear can also be quite distressing. There is also some sharp linear fluid intensity along the upper margin & anterior edge of the glenoid, which may mimic labral injury, but represent sublabral foramen & recess.
So, in summary, you have got some ligament injury and bone bruise.
Thanks and regards.
Thank you doctor,
Thank you so much for helping me.
Hi,
Welcome back to icliniq.com.
Thanks for getting back to us. Actually, there is not a specific severity grading for rotator interval tears. The classification only says that surgery may be required if the tear is "large enough" (which seems so on the MRI) and produces significant symptoms (as assessed by the orthopedician). So, I think your next course of action would be to consult an orthopedics or trauma surgeon and follow their advice. I wish you all the best.
Hello doctor,
I just got another MRI scan done because my doctor wanted more recent pictures to be taken. From what you can see, can you tell if the problem with the rotator interval is still present or if it is just the bone bruise?
Thank you.
Hello,
Welcome back to icliniq.com.
After examining your recent MRI (attachment removed to protect the patient's identity) and comparing it with the previous MRI that is three months old, I find that both the bone bruise and the rotator interval tear are significantly improved (in fact, it took me some time to locate them in the new images, as they are now subtle). So, I feel it is good news for you.
It also means that your doctor did a prudent job asking for a recent scan before going for a decision. I hope you will feel relieved now and will soon progress toward recovery.
Best wishes.
Hello doctor,
That is great, thank you. I also have another question. The doctor said that she did not recognize anything but the bone bruise (on the old MRI), and she wanted a more recent MRI picture to see how the bruise developed. So do you think the way the rotator interval is progressing would be enough?
Hello,
Welcome back to icliniq.com.
From the appearance of the present MRI and the significant improvement compared to the previous, I feel you need not make haste, i.e., about changing doctors, etc. However, I feel that both rotator interval and bone bruise are quite obvious in the earlier MRI.
Anyway, the bottom line is that things are improving, and if you do not have significant pain in your shoulder, you can wait and see.
Best wishes.
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