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HomeAnswersOrthopedician and Traumatologyshoulder painI am experiencing shoulder problems. Please suggest.

Based on a shoulder MRI, will the shoulder improve?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Atul Prakash

Medically reviewed by

iCliniq medical review team

Published At May 20, 2017
Reviewed AtMay 21, 2024

Patient's Query

Hello doctor,

I have had shoulder problems since high school. I played field hockey at school, club, provincial, and national school teams. And I was also in the swimming, volleyball, life-saving, and club tennis team in school, club, provincial and national schools. I played squash socially. I had a bursa removed when I was 16 and had an acromioplasty done at 18. I also had rotator cuff repair, removal of calcification, removal of a bursa, and acromioplasty at 39. The pain has not gone away at all, so I got an MRI done. I have no idea what it means. Will my shoulder get better or am I facing a life of pain? Any help or advice will be appreciated. The MRI report read, fraying of the supraspinatus tendon footprint with partial fissures but no full-thickness defect, adequate rotator cuff muscle, and volume quality still present with less than the third fatty changes. Moderate subacromial subdeltoid bursitis changes. The relatively tight glenohumeral joint capsule, specifically around the axillary recess there is pericapsular thickening and scarring with also slight subcoracoid synovitis changes, changes can be indicative of early adhesive capsulitis. The findings are glenohumeral, normal centering of the humeral head on the glenoid. Three anchors at the greater tuberosity of the humeral head due to previous rotator cuff repair. Anchor anterior proximal humeral shaft related to previous biceps tenodesis. No current significant bony edema of the humeral head or Hill-Sachs lesions. Preservation of convex glenoid contour. No prominent chondral delamination. Acromioclavicular, previous acromioclavicular decompressive surgery with a wide space and edema, also postsurgical changes in the acromion. Lateral acromial ossicles and a slight lateral overhang of the acromion. Rotator cuff, previous supraspinatus repair, currently the tendinous followed to its insertion, however partial tears and fissuring of the tendon footprint but no tendon retraction or full-thickness defect noted. the infraspinatus and teres minor appear intact. Subscapularis appears intact, with a thin sliver of the residual previous biceps tendon overlying the tendon footprint and slight insertional tendinosis. Central fatty changes of less than one-third in the rotator cuff muscles but still adequate rotator cuff muscle volume and quality present. Biceps, previous biceps tenodesis with only a small residual fragment of the previous tendon visualized. Labrum, fraying of the superior labrum. Anteroinferior and posteroinferior labrum appear intact. The joint capsule and glenohumeral ligaments, a relatively tight glenohumeral joint capsule, especially around the axillary recess with also pericapsular thickening and synovitis, which can be indicative of early adhesive capsulitis, also slight subcoracoid synovitis changes. Superior, middle, and inferior glenohumeral ligaments appear intact. Subacromial or subdeltoid bursa, moderate bursitis changes. Deltoid, appears intact with moderate fatty changes.

Answered by Dr. Atul Prakash

Hello,

Welcome to icliniq.com.

The MRI report is telling us of the previous surgeries that the shoulder has had. Currently, there is a fresh partial thickness tear of one of the rotator cuff muscles. There is also some changes that suggest that you may be having early stages of frozen shoulder. Both the findings mentioned above can lead to pain. I feel that pain from both conditions in isolation, would not have been difficult to manage. But, a shoulder such as yours which seems to have been put through some rigorous and complex changes, together suggests that you will have to look after this shoulder from now on so as to prolong its life. Overhead, repeated activity, and sudden jerky movements are to be avoided. You need good physiotherapy to help to maintain a full range of motion of the shoulder. At present no surgery is indicated. Your doctor may try a joint injection of steroids to help with the pain.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Atul Prakash
Dr. Atul Prakash

Orthopedician and Traumatology

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