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  1. #1
    Registered User madiyaan's Avatar
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    Unhappy Shoulder MRI Result (labrum tear + supraspinatus thickening)

    I don't normally post here, but thought I might get good input after my shoulder started having issues.

    A little background:
    I am a newbie in terms of weight training. I started having clicking with no pain in the shoulder in August 2007. I don't remember any painful accident on or off the gym just before that (though I did train pretty hard around that time). [The clicking happens when I do lateral raises (unweighted or weighted), especially with the thumb pointed down. With front raises, unless I do them weighted with decent weight, it doesn't happen. The clicking/popping/grinding angle is between 80 to 110 degrees. It is a series of clicks rather than just one.]

    At first I thought it would go away and didn't do anything about it. Showed it to 2 doctors in 2008 and they told me to do RC exercises. After August 2008 it got slightly worse and there is no slight pain with the click.

    In 2009 I tried PT again and showed it to another doctor who ordered x-rays and MRI. Supraspinatus outlet view x-ray showed an acromion bone spur (sorry, I don't have a picture of the x-ray). I got the MRI done and the report. The doctor now says that I have an anterior labrum tear with some supraspinatus thickening. The pain is caused when the anterior labrum is caught by the humerus. This also causes the audible and palatable click when the shoulder moves through the 90 degree lateral raise motion.

    He gave me a cortisone shot today and will determine if I need something bigger (surgery) to fix the labrum tear/fraying if it doesn't help. He did tell me that the labrum tear is not a SLAP one.

    Here is the MRI report:

    Study: MRI of the left shoulder without contrast
    Findings: The acromioclavicular joint is unremarkable.

    There is diffuse thickening of the posterior aspect of the supraspinatus tendon, without focal tearing. The remaining portions of the supraspinatus tendon are unremarkable. The infraspinatus, teres minor and subscapularis tendons are unremarkable. No muscle atrophy of the rotator cuff is identified.

    The biceps tenon is unremarkable. There is abnormal increased signal within the anterior labrum (axial sequence, images 12, 15) of unclear etiology. Further evaluation is limited owing to lack of significant joint effusion. There is no associated Hill-Sachs deformity.

    The humeral head is normally situated. Normal marrow signal intensity is seen.

    Impression:
    1. Abnormal signal intensity within the anterior labrum of unclear etiology. Further evaluation is limited owing to lack of significant joint effusion. An MR arthrogram is recommended for further evaulation.
    2. Mild tendinosis of the posterior aspect of the supraspinatus tendon, without tearing.


    My question to you guys it this:

    Has anyone had something similar to this? How serious is this injury? Can you do swimming/weight lifting with this?

    Thanks,
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  2. #2
    Registered User erokjenkins's Avatar
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    Originally Posted by madiyaan View Post
    I don't normally post here, but thought I might get good input after my shoulder started having issues.

    A little background:
    I am a newbie in terms of weight training. I started having clicking with no pain in the shoulder in August 2007. I don't remember any painful accident on or off the gym just before that (though I did train pretty hard around that time). [The clicking happens when I do lateral raises (unweighted or weighted), especially with the thumb pointed down. With front raises, unless I do them weighted with decent weight, it doesn't happen. The clicking/popping/grinding angle is between 80 to 110 degrees. It is a series of clicks rather than just one.]

    At first I thought it would go away and didn't do anything about it. Showed it to 2 doctors in 2008 and they told me to do RC exercises. After August 2008 it got slightly worse and there is no slight pain with the click.

    In 2009 I tried PT again and showed it to another doctor who ordered x-rays and MRI. Supraspinatus outlet view x-ray showed an acromion bone spur (sorry, I don't have a picture of the x-ray). I got the MRI done and the report. The doctor now says that I have an anterior labrum tear with some supraspinatus thickening. The pain is caused when the anterior labrum is caught by the humerus. This also causes the audible and palatable click when the shoulder moves through the 90 degree lateral raise motion.

    He gave me a cortisone shot today and will determine if I need something bigger (surgery) to fix the labrum tear/fraying if it doesn't help. He did tell me that the labrum tear is not a SLAP one.

    Here is the MRI report:

    Study: MRI of the left shoulder without contrast
    Findings: The acromioclavicular joint is unremarkable.

    There is diffuse thickening of the posterior aspect of the supraspinatus tendon, without focal tearing. The remaining portions of the supraspinatus tendon are unremarkable. The infraspinatus, teres minor and subscapularis tendons are unremarkable. No muscle atrophy of the rotator cuff is identified.

    The biceps tenon is unremarkable. There is abnormal increased signal within the anterior labrum (axial sequence, images 12, 15) of unclear etiology. Further evaluation is limited owing to lack of significant joint effusion. There is no associated Hill-Sachs deformity.

    The humeral head is normally situated. Normal marrow signal intensity is seen.

    Impression:
    1. Abnormal signal intensity within the anterior labrum of unclear etiology. Further evaluation is limited owing to lack of significant joint effusion. An MR arthrogram is recommended for further evaulation.
    2. Mild tendinosis of the posterior aspect of the supraspinatus tendon, without tearing.


    My question to you guys it this:

    Has anyone had something similar to this? How serious is this injury? Can you do swimming/weight lifting with this?

    Thanks,
    i have actually been experiencing similar symptoms for years...however mine a bit different...it hurts to the point of numbing tingling pain if i throw a baseball, football for more than 20 mins or so...and also sometimes painful to sleep with arm outstretched. also, both shoulders feel like cement mixers with rocks tumbling (like if i do RC exercises its very clicky and noisy). not too much pain when i lift though...any of this sound similar to your experience with the issue? i have always thought something serious was going on in there but just never checked it out...anybody else feel free to help us out...
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  3. #3
    Registered User madiyaan's Avatar
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    Originally Posted by erokjenkins View Post
    i have actually been experiencing similar symptoms for years...however mine a bit different...it hurts to the point of numbing tingling pain if i throw a baseball, football for more than 20 mins or so...and also sometimes painful to sleep with arm outstretched. also, both shoulders feel like cement mixers with rocks tumbling (like if i do RC exercises its very clicky and noisy). not too much pain when i lift though...any of this sound similar to your experience with the issue? i have always thought something serious was going on in there but just never checked it out...anybody else feel free to help us out...
    When I do RC exercises, it does click but at specific angles. My clicking is audible and palpatable (you can feel it if you put your hand on top of the shoulder while the shoulder moves through a certain range of motion). I also don't have too much pain while lifting (only happens at 90 degree angle with arms in a lateral position). Also if I slowly do a lateral raise, I can feel the impending click and just before it happens it feels pinchy and unstable in that position. After the click it moves to a more stable position and then when I drop the arm, it again moves back to the original position.
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  4. #4
    Registered User erokjenkins's Avatar
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    Originally Posted by madiyaan View Post
    When I do RC exercises, it does click but at specific angles. My clicking is audible and palpatable (you can feel it if you put your hand on top of the shoulder while the shoulder moves through a certain range of motion). I also don't have too much pain while lifting (only happens at 90 degree angle with arms in a lateral position). Also if I slowly do a lateral raise, I can feel the impending click and just before it happens it feels pinchy and unstable in that position. After the click it moves to a more stable position and then when I drop the arm, it again moves back to the original position.
    yeah i can feel the clicking as well when i raise my shoulder...it is def only at certain angles...like if i do large circular motions it clicks if on the forward part of the rotation i angle the arm inward toward my chest then it clicks...maybe i should make an appointment??
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  5. #5
    Registered User madiyaan's Avatar
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    Originally Posted by erokjenkins View Post
    yeah i can feel the clicking as well when i raise my shoulder...it is def only at certain angles...like if i do large circular motions it clicks if on the forward part of the rotation i angle the arm inward toward my chest then it clicks...maybe i should make an appointment??
    You should definitely get it checked, in my opinion. Though my problem has not been solved by going to the doctor (he just gave a cortisone shot today and asked me to rest for a month), at least the MRI was done and I know something I didn't know before.

    I'll post here after about a month after my next appointment with the doctor about what he says.
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  6. #6
    Registered User threedrink's Avatar
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    Originally Posted by madiyaan View Post
    I don't normally post here, but thought I might get good input after my shoulder started having issues.

    A little background:
    I am a newbie in terms of weight training. I started having clicking with no pain in the shoulder in August 2007. I don't remember any painful accident on or off the gym just before that (though I did train pretty hard around that time). [The clicking happens when I do lateral raises (unweighted or weighted), especially with the thumb pointed down. With front raises, unless I do them weighted with decent weight, it doesn't happen. The clicking/popping/grinding angle is between 80 to 110 degrees. It is a series of clicks rather than just one.]

    At first I thought it would go away and didn't do anything about it. Showed it to 2 doctors in 2008 and they told me to do RC exercises. After August 2008 it got slightly worse and there is no slight pain with the click.

    In 2009 I tried PT again and showed it to another doctor who ordered x-rays and MRI. Supraspinatus outlet view x-ray showed an acromion bone spur (sorry, I don't have a picture of the x-ray). I got the MRI done and the report. The doctor now says that I have an anterior labrum tear with some supraspinatus thickening. The pain is caused when the anterior labrum is caught by the humerus. This also causes the audible and palatable click when the shoulder moves through the 90 degree lateral raise motion.

    He gave me a cortisone shot today and will determine if I need something bigger (surgery) to fix the labrum tear/fraying if it doesn't help. He did tell me that the labrum tear is not a SLAP one.

    Here is the MRI report:

    Study: MRI of the left shoulder without contrast
    Findings: The acromioclavicular joint is unremarkable.

    There is diffuse thickening of the posterior aspect of the supraspinatus tendon, without focal tearing. The remaining portions of the supraspinatus tendon are unremarkable. The infraspinatus, teres minor and subscapularis tendons are unremarkable. No muscle atrophy of the rotator cuff is identified.

    The biceps tenon is unremarkable. There is abnormal increased signal within the anterior labrum (axial sequence, images 12, 15) of unclear etiology. Further evaluation is limited owing to lack of significant joint effusion. There is no associated Hill-Sachs deformity.

    The humeral head is normally situated. Normal marrow signal intensity is seen.

    Impression:
    1. Abnormal signal intensity within the anterior labrum of unclear etiology. Further evaluation is limited owing to lack of significant joint effusion. An MR arthrogram is recommended for further evaulation.
    2. Mild tendinosis of the posterior aspect of the supraspinatus tendon, without tearing.


    My question to you guys it this:

    Has anyone had something similar to this? How serious is this injury? Can you do swimming/weight lifting with this?

    Thanks,
    I can't help much other than to say if they recommend an arthrogram you should do it. It's the only way to get a good view of the labrum. surprised they didn't do it with the first MRI.
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  7. #7
    Registered User threedrink's Avatar
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    make sure they order the arthrogram so you don't have to do it twice.
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  8. #8
    Registered User cmcgui26's Avatar
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    I dislocated my shoulder back at the end of August, started doing physio after two weeks. It gradually got better but following advice from a couple of guys on here, I ordered up an MRI Arthogram (contrast shot is unpleasant as hell!!) anyway, long story short is that I had a labrum tear (bankhart) and a slight Hill Sachs lesion ( dent in the top of the humeral head). My orthopedic surgeon advised that I could potentially go without the surgery however there would be a relatively high chance of redid locating down the line. By the time surgery came round, I'd say that mine was fine for day to day activities and I was getting back into the gym lightly (didn't attempt any overhead pressing and flexibility was still reduced which prevented me from being able to grip the bar for squats) but I experienced a number of the symptoms you describe.

    I'm now two weeks post op and really glad I went for it - it's still too early to judge the surgery and I know that the full recovery process takes a while but hopefully that's it sorted now!!

    My advice would be to get the MRI Arthogram and at least that way, you know exactly what's going on in there and can then make a decision based on what you want/expect from the shoulder and the type of activities you partake in.

    If you do decide to go with the surgery or have any questions about it then feel free to PM me.
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