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Ken
Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6559
Experience:  Working as a Doctor who Cares since 2001.
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Had acute shoulder pain for 7 months. MRI shows extensive degenerative

Resolved Question:

Had acute shoulder pain for 7 months. MRI shows extensive degenerative changes as AC joint with juxta-articular bone marrow oedema and joint hypertrophy. Minimal degree of signal heterogeniety seen in supraspinatus, representing focal tendinopathy. What does all this mean? Have been signed off sick for 6 months and just want to return to work.
Submitted: 3 years ago.
Category: Medical
Expert:  Ken replied 3 years ago.
Hello,

I am Dr Ken and I will be helping you today.

MRI is an imaging technique to look for soft tissue and bones {generally used for joints}.

As you grow older the joints show degenerative changes like new bone formation {osteophytes}, reduced joint space, increased density of the bones {sclerosis}. With you similar changes are seen at AC joint {acromio-clavicular joint}. Whenever there are degenerative changes at the joint surrounding bones get inflamed and may show edema {as seen with you - juxtra-articular edema}. Surrounding the bones of shoulder joint are tendons like supraspinatus, subscapularis, infraspinatus and teres minor. These tendon may show changes like sprain or tear due to arthritis in the adjoining joint. In your case heterogeneous signal indicate sprain. No tear relieves me. Tendinopathy is inflammation of the tendon.

Degenerative changes at any joint are treated according to severity of the disease. The treatment mainly consists of - Rest to the joint till pain subsides/ cold compress/ analgesics {oral or topical}/ steroid shots in the joint {these reduce inflammation and so the pain significantly}/ physiotherapy. Surgery is the last resort {I do not see a need of it with you}.

Wish you well.

Best
Customer: replied 3 years ago.

You have answered what I already know. Does it mean it could be arthritis? If so what treatment, have been on tramadol for 6 months now and just want to go back to work. How much rest is needed as 6 months has passed and still as painful as before if not worse. Surely that would have been enough rest?

Expert:  Ken replied 3 years ago.
I am sorry that you were not happy with the answer.

Arthritis is inflammation of the joint. It can be due to varied causes like - Infective/ rheumatoid or degenerative {one which you have}.

Six months rest is good enough. I think you need a more potent analgesic and I would also think of having steroid shot in the shoulder. Steroid reduces inflammation significantly. One generally is pain free for 6 to 12 months after one shot. I am sure you will be able to work as before after the shot.

Good Luck

Customer: replied 3 years ago.

Already had 2 shots but to no avail. Just been left in pain! Getting desperate now, especially as I need to work to support my family

Expert:  Ken replied 3 years ago.
I do understand.

You may try some other medicines or combinations - Gabapentin/Pregabalin. Talk to your doctor for surgical intervention if needed. Osteophytes may press on the underlying tendon causing pain. If this osteophyte is removed the pain reduces. Scopy may help.
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