Do you notice any abnormalities in my right shoulder MRI?

Hello,

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I have gone through your query and also seen the MRI images sent by you (attachment removed to protect patient identity). You have mentioned that the injury to your shoulder was a few years back. As you have described, there was a sudden pull, and I feel that it has resulted in some soft tissue insult in your joint. This could be a joint capsule, tendon injuryor injury to supporting structures like the labrum. Commonly, we have to rule out an injury to the rotator cuff, which is a very important dynamic shoulder stabilizer. Also, the MRI images show edema inside the joint. It indicates inflammation and because of this, you are having pain. I cannot clearly tell you whether the rotator cuff is intact or not because an adequate number of images are not there. So, my advice for you will be the following. Consult your specialist doctor, discuss with him or her, and take treatment with consent. Get a few blood tests like CBC (complete blood count), ESR (erythrocyte sedimentation rate), and CRP (C-reactive protein) done to see the elevation of inflammatory markers. Send all MRI images so that I can see the joint in detail and tell you whether there is a soft tissue, which is damaged. Start with physical therapy for increasing flexibility followed by strengthening of shoulder muscles. One thing you mentioned is the winged scapula for which I need to see the clinical picture, and nerve conduction studies will be required. Also, a shoulder X-ray (anteroposterior and axillary views) is required. It will also be great if you can send me relevant pictures of your affected shoulder from the front and back region. Can you also tell me the current range of your shoulder movement? Once I have this information, I can see it in detail and let you know what will be the correct line of management.