How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Ken Your Own Question

Ken
Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6558
Experience:  Working as a Doctor who Cares since 2001.
25541092
Type Your Medical Question Here...
Ken is online now

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: 2 years ago.
Category: Medical
Expert:  Ken replied 2 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 2 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 2 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 2 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 2 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.
Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6558
Experience: Working as a Doctor who Cares since 2001.
Ken and 3 other Medical Specialists are ready to help you

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
< Previous | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
 
 
 

Meet The Experts:

 
 
 
  • Family Physician

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
< Previous | Next >
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
  • http://ww2.justanswer.com/uploads/DO/DoctorRich/2012-9-12_72454_Doctorweb.64x64.jpg Dr. Natasha's Avatar

    Dr. Natasha

    Doctor

    Satisfied Customers:

    7887
    American Board Certified in Emergency Medicine, Ivy League trained
  • http://ww2.justanswer.com/uploads/DR/DrK99/newpic2.64x64.jpg Dr. K.'s Avatar

    Dr. K.

    Board Certified MD

    Satisfied Customers:

    255
    Board certified with experience in primary care.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjtu60wne/2011-2-14_183449_passportphoto2.64x64.jpg docwithheart's Avatar

    docwithheart

    Board Certified Physician

    Satisfied Customers:

    0
    Board certified pediatrician, with special experience in general pediatrics, hospital pediatrics, and pediatric cardiology
  • http://ww2.justanswer.com/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Board Certified Physician

    Satisfied Customers:

    12373
    20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.