You are here:

Radiology/Possible retear of rotator cuff

Advertisement


Question
Hello,
  I had a full thickness tear of my supraspinatus tendon. I had surgery in November of last year, they put a anchor in and stitched the tendon up. Recovery went great, until 12 weeks after surgery. I was on vacation, my suitcase slipped when I was rolling it. I grabbed for it and saved my 50 pound suitcase, but the shoulder I do not know??? That was the end of January. We have tried physical therapy, ultrasound, and now a cortisone shot. The shot has taken much of the pain away, but I have no strength in it like I had previous to the suitcase injury. Had a Mri done, I was wondering if you could give me some insight of the results of my Mri? I realize it is very hard to guess what the test showed but it is so vague tear - maybe not?? I really do not want to have surgery again if I can rehab it.
   Technique: multisequence, multiplanar,, noncontrast Mri of right shoulder.
   Findings: in the distal supraspinatus tendon near the surgical anchor, there is an area of signal measuring approximately 1 cm which likely represents a small tear of the rotator cuff. This tear predominatly involves some of the bursa surface fibers and approximately 75% of the tendon thickness but could be full thickness. However, there is no adjacent increased fluid to suggest a large, full thickness rotator cuff tear. This could also be the post surgical appreance in this patient given that there is a surgical anchor in close proximity to this area.
AC joint has minimal degenerative changes. There is some slightly increased fluid in the subacromial/subdeltoid bursa near the mid supraspinatus tendon whic, given its location and quantity is nonspecific. Marrow signal is nonspecific. Labrum is grossly intact on a non-arthrogram study, with some variability of the anterior superior labrum that could be a normal variant but it would be difficult to exclude a small tear in this location, especially on a non-arthrogram study.

Impression:
1.  Some irregularity and thinning of the rotator cuff near the surgical site could be post surgical changes although a small recurrent tear could have similar appearance. There is no large full thickness rotator cuff tear present.
2. Mild degenerative changes of the labrum.

What does these results mean? The surgeon told me if there was a tear we would have to go in an fix it. This report does not really say there is a tear. Sorry so long, thanks for your time.

Answer
Hello Deb,

Well, I am not sure I can help much here.  MRI describes findings that may be postsurgical or new since surgery.  The best thing to do is to have a pre - op MRI compared with the new one.  If that is not possible or still doesn't answer the question (what was there before and how it looks now) then another option (perhaps even better option) is to repeat MRI now and compare the MRI you describe with a new MRI and see if that possible tear is better or gone or stable.
The difficult part after surgery is to figure out what is related to surgery and what is a new injury and sometimes it is very very difficult and require additional follow up to see how things evolve.  Also, you surgeon if young enough may be able to read MRI very well and correlate with what he expects to be a post operative change and what is not.  he was there, so in theory he should know what he did.
Hope this helps somewhat.
MK

Radiology

All Answers


Answers by Expert:


Ask Experts

Volunteer


Michael K.

Expertise

Almost any kind of questions regarding any types of radiology exams, procedures, meaning of radiology reports etc...

Experience

12 year experience in the field of radiology

Organizations
American Society of Neuroradiology, Senior Member Society of Pediatric Radiology, Active Member

Publications
Radiology Seminars in pediatric neurology American Journal of Roentgenology American Journal of Neuroradiology

Education/Credentials
Board Certified in Diagnostic Radiology Additional Certificate of Qualification in Neuroradiology

©2016 About.com. All rights reserved.