diagnosis, based on mri done late march 2013
key points from mri
my thoughts 2-4-13
relationships, causation
- i currently experience right shoulder pain and incapacity
- i have had persistent shoulder joint instability since (3) happened
- (3) was caused by an accident in the gym in 1983 (ie 30 years ago)
- (3) made me highly susceptible to (2)
- (2) can cause great pain, distress and short-term incapacity
- multiple (2) events compromised my shoulder anatomy
- multiple (2) events caused, or exacerbated my (1)
- my (4) and (5) may be contributors to, and /or symptoms of my (1)
- basic gym exercise may expose my compromised shoulder anatomy
- basic gym exercise may exacerbate my compromised shoulder anatomy
more about (2)
- (2) can result in associated injuries including:
* stretched or torn tendons and other soft tissue
* chronic inflammation and the formation of scar tissue
* adjoining muscle atrophy and/or muscle over-compensation
* resulting in muscle weakness and imbalances
- always active, playing sport etc, (2) has occurred as many as 10 times in a year
- (2) is rare now, due to better shoulder strength, via gym exercise, and better awareness
- but longer term, (2) has compromised my normal shoulder anatomy
- and the more anatomy is compromised, the more injuries are likely
- the more injuries, the more shoulder anatomy may be compromised
- ie a self-exacerbating cycle
technical breakdown - mri report dated 21-3-2013
1 - acromio-clavicular joint:
key points from mri
- internal impingement syndrome
- subluxtion of shoulder joint
- extensive tear of labrum
- degeneration of AC joint
- mild bursitis
my thoughts 2-4-13
relationships, causation
- i currently experience right shoulder pain and incapacity
- i have had persistent shoulder joint instability since (3) happened
- (3) was caused by an accident in the gym in 1983 (ie 30 years ago)
- (3) made me highly susceptible to (2)
- (2) can cause great pain, distress and short-term incapacity
- multiple (2) events compromised my shoulder anatomy
- multiple (2) events caused, or exacerbated my (1)
- my (4) and (5) may be contributors to, and /or symptoms of my (1)
- basic gym exercise may expose my compromised shoulder anatomy
- basic gym exercise may exacerbate my compromised shoulder anatomy
more about (2)
- (2) can result in associated injuries including:
* stretched or torn tendons and other soft tissue
* chronic inflammation and the formation of scar tissue
* adjoining muscle atrophy and/or muscle over-compensation
* resulting in muscle weakness and imbalances
- always active, playing sport etc, (2) has occurred as many as 10 times in a year
- (2) is rare now, due to better shoulder strength, via gym exercise, and better awareness
- but longer term, (2) has compromised my normal shoulder anatomy
- and the more anatomy is compromised, the more injuries are likely
- the more injuries, the more shoulder anatomy may be compromised
- ie a self-exacerbating cycle
technical breakdown - mri report dated 21-3-2013
1 - acromio-clavicular joint:
- mild to moderately degenerative disintergration
- small oedema with prominent "dorsal capsular synovitis, and resultant swelling
- [bone] spurs - no significant inferior-directed ones, and no arch ones
- bursa is mildly thickened,
- contains a small amount of fluid
- cystic changes
- these are located in the sub-cortical postero-superio area
- specifically - underneath the "infraspinatus-posterior supraspinatus fibers"
- they extend "underneath the bare area, to the margin of tuberosity-footprint attachment"
- there is also diffuse mild hyperintensity of the the overlying anterior fibres of the infraspinatus, and of the posterior fibres of the supraspinatus
- particularly on the undersurface
- this is associated with tendinopathy
- it is also associated with "deep articular surface tearing of the anterior fibers of the infraspinatus and the posterior fibers of the supraspinatu"
- extensive tear in the post-superior labrum
- extends from bicep attachment, inferiorly, to involve the inferior labrum
- signs of further tearing in the anterior labrum
- ie linear high signal in its mid-superior aspect
- but the anterior labrum is better preserved
- long head of the bicep tendon is meant to be within the groove with a small sheath effusion
- however, it will "sublux up out of the superior aspect of the groove
- and it also has some "diffuse high signal" within its intra-articular portion
- this would be "compatible with mild tendonitis"
- there is also some "high signal at the attachment of the subscapularis"
- this would be compatible "mild tendanopathy and [ ] small intrasubstance tears"